LIBRARY 

OF  THE 

University  of  California. 

Class 


Currents  of  High  Potential 

of  High   and    Other    Frequencies 


BY 

WILLIAM   BENHAM  SNOW,   M.  D. 

Author  of  "A    Manual  of  Electro-Static   Modes  of  Application,   Therapeutic!, 
Radiography  and   Radiotherapy,"    "Currents  of  High  Potential  of  High 
and  Other  Frequencies,"    "Therapeutics  of  Radiant  Light  and 
Heat  and  ConvectiTe  Heat,"   Editor  of  the  Journal 
of  Advanced  Therapeutics,  and  Late  Instruc- 
tor in  Electro-Therapeutics  in  the  N.  Y. 
Post-Graduate  School,  Etc. 


SECOND  EDITION 


NEW    YORK 

SCIENTIFIC  AUTHORS'   PUBLISHING  CO. 
191 1 


Copyright,  iqii 

BY 

WILLIAM  BENHAM  SNOW,  M.  D 


THE     BRANDOW    PRINTING     COMPANY 
ALBANY.     N.     Y. 


PREFACE  OP  FIRST  EDITION 

The  study  of  the  application  of  currents  of  high  pot<'n- 
tdal  associated  with  variations  in  current  strength  and 
frequency  as  applied  in  therapeutics  is  engaging  the  at- 
tention of  the  medical  profession  as  never  l>efore.  Many 
valuable  treatises  have  been  contributed  to  the  subject 
of  currents  of  high  frequency  and  gi^at  potential,  but  in 
no  work  publishcnl  has  due  attention  been  accorded  to 
great  potential  in  association  with  the  lower  rates  of 
frequency. 

In  view  of  the  marked  contrast  in  the  physiological 
effects,  in  many  essential  particulars,  of  the  different 
fre<iuencies  and  for  the  purpose  of  calling  attention  to 
the  relative  actions  of  currents  derived  from  different 
types  of  apparatus,  it  is  pur^xMsed  here  to  consider  the 
high-jM)t(Mitial  currents  broadly. 

The  author  is  sensible  of  the  fact  that  in  a  tield  to  which 
so  many  able  writers  are  contributing,  there  is  certain 
to  be  a  diversity  of  opinion  ami  development  of  new 
methods  and  apparatus.  Noting  that  the  value  of  many 
features  and  methods  which  have  been  denionstrat<'d  in 
his  private  and  clinic  practice  has  not  been  recognized 
by  other  writers,  he  is  induced  to  add  the  same  to  the 
literature.  Enough  consideration  has  not  been  accorded 
by  previous  writers  to  the  high-potential  currents  of  the 
lesser  rates  of  frecjuency,  which  have  been  demonstrat<Ml 

v 


vi  PREFACE 

to  exert  the  most  favorable  effects  upon  acute  and  chronic 
inflammatory  conditions,  especially  those  in  which  no 
germs  are  present.  It  is  the  writer's  object  to  show  the 
reasons  for  contrasting  these  currents,  and  to  endeavor 
to  call  attention  to  the  importance  of  a  degree  of  dis- 
crimination in  other  particulars  not  generally  observed. 
The  vacuum  tul>es  which  have  come  into  .such  general 
use  during  the  past  two  years  as  one  of  the  mediums  for 
administering  high-potential  currents  call  for  more  con- 
sideration than  has  been  previously  accorded  them.  With 
the  object  of  calling  to  the  mind  of  the  profession  the 
broad  scope  of  indications  for  their  employment,  many 
designs  for  special  cases  are  presented  as  suggestions, 
with  the  realization  that  they  will,  in  a  few  years,  be 
replaced  by  others  in  many  instances  better  adapted  to 
many  conditions. 

William  Benham  Snow. 


rUEFAC'l':  OF  SFCONl)   FDITrON 

Devem)1»mknts  ill  mctluxls,  apparatus,  and  tlio  tliera- 
peiitics  of  hi<ili  fi'tHjuent-y  cnrreiits  since  the  publication 
of  the  first  edition  of  this  work,  has  made  it  neei'ssary  to 
revi;!ie  it  throujihout,  and  to  add  numerous  cut.s  of  the 
types  of  hi<j:ii  freijuency  transformers  and  other  apparatus 
now  in  usi\ 

Of  supreme  importance  in  electro-therapeutic  methods 
as  in  others  is  the  estahlishment  upon  an  accurate  basis 
of  wstandards  as  to  the  piiysioloj^ical  action,  ettects  and 
indications  for  the  employment  of  the  various  modalities. 

The  physiological  actions  of  the  electrical  currents  and 
other  ph^'sical  a«;ents  when  once  clearly  demonstrated  and 
detined,  iH'come  tixed  laws  for  their  practical  and  scientific 
employment.  The  writer  has  made  every  ettort  in  his 
power  in  this  direction  in  his  study  and  employment 
of  all  nuKlalities,  with  a  view  to  determining?  the  scientific 
relation  of  each  m(>dality  to  therapeutics. 

In  a  pajHT  re<id  before  the  American  Electro-Thera- 
peutic Association  in  Ho.ston,  on  S<'])tember  18,  1907,  at- 
tention was  called  by  the  writer  to  the  iinj»ortance  (►f  tlie 
estiiblishment  t>f  pht/siolof/icdl  laws  in  thcraprutics.  The 
followin*;  year  a  committee  devoted  to  the  Standardization 
of  riiysical  TheraiM'utic  Mea.sures  l>e;;an  its  laboi-s.  In 
this  wx)rk  the  written  had  the  co-operation  of  able  collabora- 
tors \v]\i*  have  continued  to  assist  in  establishing  a  scien- 
titic    iKisis   f(>r   the   employment   of   el<M-tricity    and    <»thej' 

vii 


viii  PREFACE 

modalities.  In  this  work  the  findings  and  standards 
adopted  by  that  committee  have  been  closely  adhered  to; 
and  we  believe  will  be  found  generally  iscientific  and 
acceptable. 

The  writer  wishes  to  express  his  appreciation  of  the 
cordial  reception  given  the  previous  edition  of  this  work. 

William  Benham  Snow. 


C  ()  X  r  E  N  T  s 

SECTION  I 
Static  Modalities 

CHAFfER  I 

Introduction 
comparison  of  the  effects  of  currents  of  various  frequency 
Study  of  High  Potential  Currents.     I^oeal  Effects  of  High  Poten- 
tial Currents.  Characteristics  of  Electricity      ....        1-5 


CHAPTER  II 

THE    STATIC    WA\*E-CURRENT,    PRINCIPLES    OF    ACTION    AND    THERAPEUTIC 

INDICATIONS 

Arrangement  for  Administering  the  Wave-current,  Description  of 
Characteristics,  Physiological  Effects  upon  Metabolism,  Muscular 
Contraction  Vibration,  and  Contraction  of  Cell  Protoplasm;  The 
Action  of  a  Current  of  One  Polarity  Explained;  Constitutional 
Effects  upon  Arterial  Tension,  the  Nervous  System,  Heat  Produc- 
tion, and  the  Secretions;  Indications  for  Its  Employment  in  Con- 
gestion and  Local  Hyperemia,  Acute  Ix)cal  Congestion,  Deep- 
seated  Conditions,  and  Syphilitic  Processes;  Relief  of  Pain,  Mus- 
cular Spasms  or  Contractions.  In  Conditions  of  Nervous  Irrita- 
bility. For  Errors  of  General  Metabolism.  For  Activity  of 
Special  Functions.     In  Conditions  of  Nervous  Inertia  .6-24 

CHAPTER  III  "^ 

THE  STATIC  INDUCED  CURRENT 

History  and  Arrangement;  Its  Use  during  Periods  of  Humidity; 
Adjustment  of  Leyden  Jars  to  Regulate  Intensities,  etc.,    .  .   25-32 

CHAPTER  IV 

DISRUPTIVE   DISCHARGES,   SPARKS 

Sparks,  Indirect  Sparks,  the  Resonator  Spark,  Therapeutic  Indi- 
cations, Various  Apparatus  Used  for  the  Production  of  the 
Resonator   Sparks 33-40 

ix 


CONTENTS 

CHAPTER  V 

THE   CONVECTIVE  DISCHARGES   OR    EFFLEtWE 

Character  of  the  Discharges,  Brush-discharge,  Method  of  Admin- 
istering Brush-discharge,  Accidents  that  Might  Occur,  Effleuve 
from  a  Coil,  Physiological  Action  of  the  Convective  Discharges, 
Action  Upon  the  Tissues,  Rubefacience,  Antiseptic  Action;  Effects 
Upon  Local  Stasis ;  Indications  for  Use ;  Range  of  Application ;  In 
Acne,  Ulcers,  and  to  the  Cavities  of  the  Body  .  .  .   41-53 

CHAPTER  VI 

HIGH-POTENTIAL   CURRENTS    WITH   VACUUM   TUBES 

Various  Color  Effects;  Effect  of  Frequency  upon  the  Phenomena; 
Clinical  Effects  of  the  Vacuum  Tube  Discharges;  Physiological 
Effects;  Stimulating  Effects;  Rubefacient  Effects;  Antizymotic 
Action;  Analgesic  Effects;  Effects  upon  Metabolism;  Muscula,r 
and  Tissue  Contraction  and  Local  Vibration;  Local  Heat  Produc- 
tion; Therapeutic  Indications,  and  Relief  of  Local  Congestion; 
Muscular  Contraction ;  Restoration  of  Secretion,  Treatment  of  Spe- 
cific Conditions;   Cataphoric  Action;   Relief  of  Pain  .  .    54-72 

SECTION  II 

High  Frequency  Currents  and  Types  of  High 

Frequency  Apparatus 

chapter  i 

COMPARISON   OF    CURRENTS    OF   HIGH    FREQUENCY   AND    HIGH    PERIODICITY 

An  Oscillatory  Current;  High  Frequency  Current;  Types  of 
Pulsatory  Current;  The  d'Arsonval  Current;  The  Tesla  Current; 
Tlie  Oudin  Current;  Variations  in  Quality  of  High  Frequency 
Currents 73-84 

CHAPTER  II 

APPARATUS 

The  Rhumkorff  Coil;  Methods  of  Winding  Rhumkorff  Coils;  Dif- 
ferent Types  of  Interrupters;  Closed  Magnetic  Circuit  Trans- 
former; High  Potential  Rotary  Rectifier;  Interrupterless  Trans- 
former; Tesla  Apparatus;  Types  of  Tesla  Coils,  so  Called;  Ap- 
paratus for  Use  with  the  Alternating  Current;  Methods  of  Cur- 
rent Transformation;  High  Frequency  Resonator     .  .  .   85-111 

CHAPTER  III 
d'arsonvalization 
Method  Known  as   Auto-Condensation;    Auto-Condensation  Cush- 
ion; Hot  Wire  Meter;   Auto-Conduction  Method;   Direct  d'Arson- 
valization 112-120 


CONTENTS  xi 

CHAPTER  IV 

TESLA.   AND    OUUIN   CUUKKNTS 

The  Tesla  Current;  So  Styled  Tesla  Current-^;  The  Oiuiin  Chir- 
rent;  Another  Arrangement  for  the  Oudin  CUirrent;  Fiilguration 
as  Applied  from  the  Oudin  Current  .121-124 

SECTION  III 

Physical  and  Physiological  Effects  and  Tiifuai'kutics 
OF  llioii  I'otential  Currents 

chapter  I 

PHYSICAL  AND  I'll YSIOI.OOICAL  ACTIONS  IN  TITERAPKUTICS 
Physical  Effects  of  High  Potential  Currents;  Pliysical  Effects  of 
Electricity;  Nerves  not  Essentially  Electrical  Conductors;  Varia- 
tion in  Effects  of  Currents  of  Different  Potential ;  Cauterant  Ac- 
tion; Electrolytic  Action;  Cataphoresis;  General  Diffusion  of 
Current;  Relative  Effects  of  Different  Methods,  Depending  upon 
Current  Characteristics;  Effects  of  d'Arsonval  Current;  Effects 
of  Static  Wave  Current;  Contraction  of  Cell  Protoplasm;  The 
Effleuve;  Ix)cal  Oxidation  and  Other  Germicidal  Actions;  Vibra- 
tory Action;    Polarization;    Ionization  ....    125-136 

CHAl^ER  ir 

CONSIDERATION    OF   PHYSIOLOGICAL   ACTIONS 

Mechanical  Effects;  Explanation  of  Potential  of  Delivery;  Tis.sue 
Contraction  from  Therapeutic  Point  of  View;  Comparison  of 
various  ways  of  Inducing  Tissue  Activity;  Thermic  Effects  of 
High  Potential  Currents;  Therapeutic  Point  of  View  of  Hype- 
remia; Treatment  of  Trauma  and  Joint  Sprains;  Treatment  of 
Chronic  Conditions;  Radiant  Energy  and  the  Cathode  Stream; 
Inducing  Hyperemia;  Roentgen  Ray  in  Treatment  of  Infection;  . 
Ix)oal  Anti.septic  and  Ciermicidal  Action  of  High  Potential  Cur- 
rents;  Radiant  Energj'  of  High  Potential  Currents  .    137-158 

CHAPTER  III 

HIGH    POTENTIAL   CURRENTS    IN    DISEASES    OF    THE    CIRCULATOKY    SYSTEM 

In  Parenchj-matous  Nephritis;  The  Study  of  Hypertension;  Nor- 
mal Blood  Pressure;  The  Causes  of  Hypertension;  Electrical 
Treatment  of  Hypertension;  Classification  of  Types  of  Hyperten- 
sion; Treatment  of  Parenchymatous  Nephritis;  Dry  Mot  Air 
Bath;  Conip«»n>atory  High  Arterial  Tension,  How  Maintained; 
Treatment  of  Hypertension  by  Diet,  Exercise  and  Higii  Frequency 
Currents;  Heart  Not  Depressed  by  d'Ar.sonvalizaticm ;  C'onsidera- 
tion  of  the  Frequency  Factor;  Methoil  of  Employing  Auto-Con- 
duction for  Treatment  of  High  Blood  Pressure  .159-180 


xii  CONTENTS 

CHAPTER  IV 

DISEASES  OF  THE  NERVOUS   SYSTEM 

Treatment  of  the  Central  Neurons;  Treatment  of  Apoplexy;  Tu- 
mors of  the  Brain;  Diseases  of  the  Spinal  Cord;  Anterior-  Polio- 
myelitis; Treatment  of  Tabes  Dorsalis;  Treatment  of  Spastic 
Paraplegia,  Lateral  Sclerosis  and  Syringo  Myelia;  Chorea  Major; 
Peripheral  Nervous  Affections;  Treatment  of  Neuritis,  Tic  Dou- 
loureaux,  and  Herpes  Zoster;  Attitude  of  Neurologists;  Neuras- 
thenia; Hysteria;  Functional  Epilepsy  and  Chorea;  Treatment  of 
Functional  Neuroses     ........   181-205 

CHAPTER  V 

THERAPEUTICS  OF  NON-INFECTED  INFLAMMATION 

Resolution  of  Stasis;  Sprained  Ankle;  Management  of  Rheumatoid 
Arthritis;  Stills'  Disease;  Infectious  Arthritis;  Pelvic  Inflamma- 
tions; Uterine  Subinvolution;  Urethral  Caruncles;  Prostatitis; 
Prognosis  in  Prostatitis;  Vessiculitis ;  Orchitis  and  Epididymitis; 
Varicocele;  Malignant  Disease;  The  Types  of  Nephritis;  Cirrhosis 
of  the  Liver;  Enlarged  Spleen;  Diabetis  Mellitus;  Atonic  Condi- 
tions; Constipation;  Phlebitis;  Varicose  Ulcers;  Affections  of  the 
Eye;  Glaucoma;  Congestions  of  the  Nasal  Passages;  Fissure  in 
Ano;  Hemorrhoids;  Contusions     ......   206-235 

CHAPTER  VI 

TREATMENT  OF  INFLAMMATION   CAUSED   BY  INFECTION 

Indications  for  Treatment;  Method  of  Applying  the  Vacuum  Tube; 
Direct  d'Arsonval  Method  of  Treating  Infection;  Hyperemia  Im- 
portant Measure  in  Treating  Infection ;  Treatment  of  Otitis  Media 
and  Other  Infections  of  the  Ear;  Pelvic  Cellulitis  and  Other  In- 
fections of  the  Pelvis;  Abscesses  of  the  Liver,  Adenitis,  Pulmonary 
Tuberculosis;  Tubercular  Arthritis;  Acute  Epididymitis;  Acute 
and    Chronic    Appendicitis;    Salpingitis        ....   236-248 

CHAPTER  VII 

METHOD   OF  EFFLUVATION   OTHERWISE   DESIGNATED   FULGURATION 

Indications  and  Technique     .......   249-251 

Glossary 253-262 


ILLUSTRATIONS 

Page 
Plate  I.  Frontispiece.     Auto-condensation 

Fig.    1.  Arrangement  for  the  Static  Wave  Current 6 

2.  Arrangement  of  the  Wave  Current  with  an  Insulated  Capacity,  12 

3.  Glass  Muffler    21 

4.  Static  Induced  Current 29 

5.  Arrangement  for   Indirect   Spark 34 

Plate  II.  Author's  Method  for  Localizing  Sparks 35 

Fig.    6.  Author's  Spark  Director 35 

7.  Chain  Holder  Used  as  Spark  Director 36 

8.  Authors  Pear  Shaped  Ball 39 

Plate  III.  Method  of  Administering  Resonator  Sparks 39 

Fig.    9.  Single   Point  Electrode 42 

10.  Multiple  Point  Wire  Brush 42 

11.  Brush  Discharge  Electrodes  Including  Glass  Glycerine  Filled 

Electrode 43 

12.  Glass  Sleeve  for  Use  with  Static  Brush  Discharge 52 

13.  Elongated    Tip   for    Use    with    Brush   Discharge    with    Glass 

Sleeves 52 

14.  Illustrating  an  Oscillatory  Impulse 74 

15.  Jerome  Kidder  Magneto 75 

16.  d'Arsonval  Current  78 

17.  Arrangement  for  Auto-Condensation 79 

18.  Arrangement  for  Tesla  Current 80 

19.  Arrangement  for  Oudin  Current 81 

20.  Wehnelt  Interrupter  87 

21.  Caldwell  Interrupter 88 

22.  Mercury  Jet  Interrupter 89 

23.  Centrifugal  Interrupter   90 

24.  Mechanical  Interrupter    91 

25.  Closctl  Magnetic  Circuit  Transformer 92 

26.  High  Potential  Rotary  Rectifier  and  Interrupted  Transformer,  93 

27.  Tlie  McCaa  Transformer 95 

28.  So  Called   Tesla  Coil 97 

29.  So  Called  Tesla    Tj-pe   for    Administering  Auto-Condensation 

and   Other  Treatments 99 

.•^0.  Rheostat 101 

31.  Inductive  Rheostat   102 

X  i  i  i 


xiv  ILLUSTRATIONS 

Page 

32.  Motor  Dynamo   102 

33.  Cooper-Hewitt  Rectifier   103 

34.  Electrolytic  Rectifier 104 

35.  Types  of  Condensers,  Leyden  Jar  and  Glass  Plate 106 

36.  Winding  of  Rhumkorff  Coil 107 

37.  Complete  Coil  Apparatus  for  High  Frequency  and  X-Ray 109 

38.  The  Step-up  Solenoid 110 

39.  Bowen  Static  Chair  Designed  by  Author 113 

40.  Austrian  Bentwood  Chair 114 

41.  Hot  Wire  Meter 116 

42.  Arrangement  for  Employing  Direct  d'Arsonvalization 119 

43.  Arrangement    for   Dr.    deKraft's   Method    for    Employing   the 

Oudin   Current    122 

44.  Showing  the  Paths  of  the  Static  Wave  Current  Through  the 

Tissues 131 

45.  Arrangement  for  Auto-Conduction 177 

46.  Vacuum  Electrode  for  Mouth  Treatment 197 

Plate  IV.  Static  Treatment  of  Pelvic  Conditions 213 

Fig.  47.  Common   Metal   Rectal   Electrode 214 

48.  Author's   Rectal    Electrode 214 

49.  Curved  Electrode  Designed  by  Dr.  Arnold  Snow 215 

50.  Glass  Vacuum  Vaginal  Electrode 215 

51.  Urethral  Electrode    216 

Plate  V.  Method  of  Holding  Rectal  Electrode 218 

Fig.  52.  Long  Rectal  Electrode 222 

53.  Surface  Electrode  with  Concave  Face 222 

54.  Single  and  Double  Eye  Vacuum  Electrodes 229 

55.  Variously  Curved  Vacuum  Tubes  for  Nasal  Treatment 230 

56.  Eustachian  Electrode   231 

57.  Electrode  for  Treating  Turbinates  and  Meatus  of  Eustachian 

Tube 232 

58.  Dr.  Tice's  Nasal  Electrode 232 

59.  Dr.  Arnold  Snow's  Hemorrhoidal  Electrodes 232 

60.  Dr.  Cannon's  Effluvation  Electrode 250 

61.  Wappler  Fulguration   Electrode 251 

Figs.  62  and  63.  Diagrams  of  Parts  of  the  Holtz  Machine 260 


SECTION  I 

INTRODUCTION 

AND 

STATIC  MODALITIES 


SECTION  I 

HIGH    POTENTIAL    CURRENTS   OF    HIGH 
AND  OTHER  FREQUENCIES 

CHAPTER  I 

INTRODUCTION 

The  study  of  currents  of  high  potential  has  opened  a 
fieUl  of  far  reaching  scope  and  possibilities  in  therapeutics 
unrecognized  by  most  physicians.  This  is  true,  and  par- 
ticularly to  be  regretted,  of  most  of  those  who  stand  high 
in  the  councils  of  the  profession. 

A  new  science  has  l>een  in  process  of  development ;  em- 
ploying technical  means  and  principles  witli  wliich  physi- 
cians are  not  generally  familiar — subjects  requiring  an 
extent  of  investigation  which  busy  men  are  generally  un- 
willing to  pursue,  preferring  to  devote  their  time  to  re- 
search in  other  directions. 

Tlie  study  of  the  employment  of  electrical  current*?, 
while  technical,  is  not  so  difficult  of  comprehension  that 
it  would  1k'  a  task  for  any  medical  man  to  acquire  the 
requisite  knowledge  for  their  scientific  em])loyment.  The 
consefjuenc<',  however,  with  those  who  begin  to  use  them 
without  lu'cessary  investigation  is  fre(inent  accidents  or 
failures,  resulting  in  subsequent  prejudice. 

It  is  not  possibb'  in  a  work  of  the  scope  of  this  volume 
to  enter  into  the  details  of  the  physics  or  the  .sources  of 
electrical  energy'.  For  such  information  the  reader  is 
referred  to  numerous  works  on  [ihysics  such  as  (lanot'.s. 

Before  the  preparation  of  the  previous  edition,  the 
tendency  was  marke<i  for  men  to  put  stress  upon  the  use 


2  HIGH-POTENTIAL  CURRENTS 

of  high  frequency  currents,  ignoring  the  importance  of  the 
static  currents  administered  with  lower  frequencies.  It 
is  with  pleasure  that  at  this  time  the  author  notes  that 
the  drift  is  to  consider  the  subject  broadly,  attaching  to 
each  class  of  currents  its  specific  indications  for  the  relief 
of  particular  conditions. 

The  writer's  investigation  of  currents  of  high  frequency 
and  high  periodicity  and  the  scientific  progress  that  has 
been  made  by  eontemporary  observers  during  the  past  five 
years,  has  led  to  a  fuller  conception  of  the  importance  of 
these  modalities,  and  to  the  differential  study  of  the  vary- 
ing qualities  and  effects  of  currents  produced  under  dif- 
ferent conditions  with  so-called  high  frequency  apparatus. 

The  establishment  of  the  claims  of  Prof.  d'Arsonval  with 
reference  to  the  treatment  of  hypertension  by  the  methods 
which  bear  his  name  fully  justifies  the  claims  of  a  few 
early  observers,  and  it  is  probable  that  they  will  soon  be 
recognized,  if  not  adopted,  by  the  profession  at  large. 

Another  action  of  high  frequency  currents  associated 
with  the  induction  of  hyperemia  on  account  of  the  thermic 
action  of  the  eurrent  is  now  recognized  by  those  familiar 
with  the  subject.  The  details  of  technique  in  this  par- 
ticular require  careful  study  and  consideration. 

The  study  of  the  high  potential  currents  from  the  stand- 
point of  frequency  and  periodicity,  especially  for  heat  pro- 
duction, induction  of  hyperemia,  and  metabolic  effects, 
seems  to  have  established  a  scientific  standard  away  from 
the  theoretical;  and  the  outlook  at  present  is  not  in  the 
direction  of  the  production  of  particular  frequencies  so 
much  as  for  the  character  of  the  current  as  to  direction 
and  thermic  action.  The  establishment  of  this  observation 
is  in  accord  with  the  production  of  special  physical  effects; 


INTRODUCTION  3 

not  a«  to  the  vibrations  piixlin'od,  but  as  to  the  actions 
thermic,  stimulating  and  alterative,  which  are  due  to  con- 
ditions of  i'urrent  strength,  and  frequency. 

The  superficial  actions  of  the  currents  in  the  induction 
of  light  frequencies,  when  passed  through  vacuum  tubes, 
is  a  phase  of  the  subject  which  calls  for  consideration  as 
to  the  effects  of  the  high«'r  frequencies  upon  the  blood. 

Local  tissue  destruction  is  another  indication  for  the 
use  of  the  high  potential  currents,  which  has  acquired  a 
recognition  by  the  adoption  of  successful  tecliuique  dur- 
ing recent  yeaTS.  The  employment  of  these  currents  for 
their  destructive  action  upon  abnormal  tissue  was  first 
describe<I  by  Riviere  and  termed  by  him  effluvation.  Kae- 
ting-PIart,  a  student  of  Riviere,  adopted  this  method,  to 
whieh  he  applied  another  name — fuUjuration — the  tech- 
nique being  the  same.  Later  differential  considerati(m  of 
the  discharges  from  the  static  current  seem  to  have  demon- 
strated a  difference  in  quality  to  w^hich  Dr.  Clarke  of 
Philadelphia  has  called  attention  in  a  recent  paper.  The 
methods  <'niployed  are  of  considerable  importance;  their 
value  having  been  demonstrated  for  the  removal  of  neo- 
plasms, adventitious  growths,  ajid  in  the  treatment  of 
various  conditJons  of  the  mucous  cavities. 

The  d'Arsonral  methods,  or  the  modem  methmls  of  using 
the  d'Arsonval  current,  occupy  a  very  important  place  iu 
the  therapeutics  of  high  potential  currents.  The  auto- 
conduction  and  auto-condensation  methods  with  the  im- 
provements by  the  manufacturers  of  apparatus  by  the 
increa.si'  of  capacity  of  stiitic  machines,  by  increase  in  the 
number  of  revolving  plates  and  the  intnxluction  of  high 
spee<l  machines,  also  with  a  larger  nunilicr  of  revolving 
plates,  has  made  it   pitssihle  to  produce  upwards  of  300 


4  HIGH-POTENTIAL  CURRENTS 

milliamperes  as  indicated  by  tlie  hot  wire  meter  wliea 
employed  in  connection  with  a  resonator.  Likewise  with 
the  improvement  in  coils  and  resonators,  it  is  possible  to 
produce  currents  of  a  milliamperage  ranging  from  300  to 
3,000  milliamperes.  With  these  currents  it  is  possible  to 
so  affect  arterial  pressure  by  the  auto-conduction  and  auto- 
eondensation  methods,  as  to  render  a  most  valuable  ser- 
vice in  the  therapeutics  of  hypertension  and  arterioscle- 
rosis ;  a  place  in  therapeutics  not  adequately  filled  by  any 
other  measures. 

The  increased  recognition  of  these  currents  for  the  relief 
of  these  conditions  is  one  of  the  greatest  advances  made 
in  the  use  of  high  potential  currents  in  recent  years,  and 
demands  the  attention  not  only  of  electro-tlierapeutists,  but 
of  the  profession  at  large,  and  the  public  as  well. 

The  thermic  action  of  the  d'Arsonval  current  by  the 
djirect  method  is  another  important  effect  which  is  receiv- 
ing more  and  more  attention,  particularly  in  the  treatment 
of  infectious  processes,  by  inducing  active  hyperemia  where 
infection  is  present.  This  method,  likewise,  is  certain  to 
receive  a  deserving  general  recognition,  and  should  be 
investigated  and  employed  in  hospitals,  research  labora- 
tories, and  by  the  profession  at  large.  Under  the  term 
diathermy,  some  recent  investigators  have  enlarged  con- 
siderably upon  its  use  advising  its  employment  in  the 
treatment  of  neoplasms  and  other  malignant  growths.  In 
this  particular  the  effects  resemble  the  methods  by  efflu- 
vation  and  oscillatory  desiccation. 

The  place  of  static  currents  in  therapeutics,  still  holds 
the  important  field  for  the  treatment  of  non-infected  in- 
flammations; a  field  which  from  present  indications  can 
never  be  filled  by  other  electrical  methods. 


INTKODUCTION  "  5 

These  subjects  are  cerUiin  each  to  deniaiid  iviiiiisite 
attention  and  recoj^nition,  each  in  its  own  particular 
field,  in  conformity  with  the  indications  from  a  scientific 
professional  point  of  view,  and  not  from  the  point  of  view 
of  the  manufacturer  who  is  often  apt  to  assert  incorrect 
opinions.  Too  often  i)hysiciaus  in  the  past  have  been  led 
into  wrong  notions  or  conceptions  as  to  the  met  hods  and 
indications  for  employing  the  various  currents  by  over 
zealous  salesmen,  who  are  often  r<'ady  to  take  advantage 
of  the  credulity  and  Hatter  the  conceits  of  the  uninitiated 
who  are  disposed  to  investigate  these  subjects.  Very  often 
the  manufacturers'  suggestions  in  these  partictilars  are 
erroneous  and  misleading  to  the  physician  who  would  suc- 
ceed were  he  to  adopt  them  in  a  properly  scientific  manni^ 
— first  to  know  what  he  wants  from  those  who  are  familiar 
with  the  subject,  and  then  to  select  his  apparatus,  and 
adopt  scientific  methods. 

Though  fully  conscious  of  the  present  status  of  scien- 
tific opinion  as  to  the  direction  and  other  characteristics 
of  electric  currents  as  recognize<l  by  authorities,  who 
teach  that  there  is  one  electricity,  and  the  o])posit(^  ]>ha.se 
is  the  aftinity  of  the  non-charged  atoms  or  inoh'cnles  for 
the  electrified  j)articles  or  ions;  the  writer  finds  t(M>  many 
phenomena  antl  physical  effects  that  are  derivetl  from  the 
employment  of  electricity,  which  do  not  substantially  ac- 
cord will)  the  present  theor}'  to  wair;iiit  its  accei)tance. 
The  writer  will  therefore  in  this  work  treat  the  subjiM't 
from  the  standpoint  of  jK)sitive  and  negative  polnrities, 
but  recognize  the  jnodern  view  Ci)ncerning  cummt  dir<'c- 
tion,  which  is  clearly  demonstrat^nl  to  flow  with  the  cathode 
stream  from  negative  to  positive  as  demonstrated  in  x-ray 
and  vacuum  tulies. 


CHAPTER  II 

THE     STATIC     WAVE-CURRENT,     PRINCIPLES     OF     ACTION     AND 
THERAPEUTIC  INDICATIONS 

This  valuable  electric  modality  has  been  known  to  the 
profession  for  so  short  a  time  that  we  believe  that  rela- 
tively few  have  appreciated  its  pronounced  effects  and 
scope  of  general  utility. 


Fig.  1.     Arrangement  for  the  Static  Wave  Current,     S.  G.    Spark-gap; 
E.  Electrode:    P.  Patient:    G.  Grounding. 

The  arrangement  for  the  current  as  shown  in  Fig.  1  was 
described  by  Jenks  and  Clarke  in  the  report  of  the  Com- 

6 


THE  STATIC  WAVE-CURRENT  7 

mittee  on  Nomenclature  as  follows:  *'  In  this  arrange- 
ment, which  the  Committee  believes  originated  with  Dr. 
W.  J.  Morton,  one  prime  conductor  of  the  static  generator 
is  grounded ;  the  other  is  connected  with  an  electrode  ap- 
plied to  the  patient,  who  is  on  an  insulated  stand.  The 
current  received  by  the  patient  is  due  to  the  spark  dis- 
charge between  the  knobs  of  the  prime  conductors.  The 
patient  forms  one  coating  of  a  Leyden  jar  condenser,  the 
other  coating  of  which  is  the  earth  and  surrounding  ob- 
jects and  walls  connected  electrically  therewith." 

"  The  greater  part  of  the  charge  and  resulting  strain 
on  the  dielectric,  air,  will  be  found  at  those  parts  of  the 
patient  and  floor  or  walls  of  the  room  that  are  nearest 
together." 

"  If  the  spark-gap  be  long,  the  time  of  charging  by  the 
small  continuous  current  will  also  be  comparatively  long, 
because  the  potential  must  be  raised  to  a  high  point  in 
order  to  produce  a  long  spark.  The  duration  of  the  dis- 
charge, which  will  probably  be  an  oscillatory  one  of  rela- 
tively high  frequency,  because  of  the  small  capacity  of  the 
condenser,  will  be  short.  The  small  continuous  charg- 
ing current  will  flow  through  the  patient  without  causing 
appreciable  sensation.  The  sudden  oscillatory  discharge 
may  flow  over  the  surface  of  the  patient  because  of 
its  high  frequency,  and  therefore  without  disagreeable 
effects.  As  the  length  of  the  spark-gap  is  diminished, 
the  time  and  amount  of  charge  becomes  less,  with  a  result- 
ing diminution  of  sensation." 

It  will  be  observed  that  in  the  arrangement  for  the  ad- 
ministration of  this  cunont  the  following  provisions  are 


8  HIGH-POTENTIAL  CURRENTS 

made:  (1)  An  insulated  platform,  for  best  results  hav- 
ing legs  8  to  9  inches  in  length,  and  being  about  two  and 
one-half  by  four  and  one-half  feet  in  size,  should  be  pro- 
vided. (2)  A  grounding  chain  or  metallic  cord  connected 
to  some  metallic  path  to  damp  earth,  for  which  the  house 
gas  or  water  pipes  are  usually  employed.  In  cases  where 
such  facilities  are  not  convenient,  a  wire  running  to  a  rod 
driven  deep  into  the  cellar  bottom  will  prove  equally  as 
good.  (3)  A  spark-gap — the  current  regulator  of  po- 
tential of  delivery — the  distinctive  feature  of  the  static 
currents — is  usually  allowed  to  discharge  between  the 
balls  of  the  discharging  rods.  When,  therefore,  the 
spark-gap  is  referred  to,  it  is  usually  considered  to  be  in 
this  position.  (4)  The  connecting  cord  and  a  metallic 
electrode  connecting  the  patient  directly  to  one  side  of 
the  Holtz  machine — the  side  opposite  the  grounding — 
completes  the  provisions. 

The  static  machine  should  give  a  steady,  uniform  out- 
put of  current  and  be  operated  at  a  rate  of  speed  which 
will  not  give  a  great  frequency  as  suggested  in  the  above 
paragraph;  lest  "  a  sudden  oscillatory  discharge  might 
flow  over  the  surface  of  the  patient  because  of  its  high 
frequency."  Because  in  the  administration  of  this  cur- 
rent the  physiological  effects  sought  are  those  derived 
from  the  passing  to  and  fro  of  the  current,  between  the 
surface  of  the  electrode  and  the  whole  surrounding  sur- 
face of  the  body  of  the  patient,  surging  back  and  forth, 
and  from  the  local  vibratory  effects  and  muscular  con- 
traction induced  in  the  tissues  beneath  the  electrode. 

The  distinctive  characteristics  of  the  wave-current,  ii 


THE  STATIC  WAVE-CURRENT  9 

will  be  obsen'ed  from  the  above  description,  are  peculiar. 
(1)  It  is  a  current  of  one  polarity  (preferably  the  i)osi- 
tive),  administered  to  the  patient  from  one  side  of  the 
static  machine,  passing  to  and  fro  from  the  whole  surface 
synchronous  with  the  discharge  at  the  spark-gap.  (2) 
The  intensity  of  the  discharge  depends  to  a  marked  de- 
gree upon  the  character  of  the  grounding — a  condition 
which  it  is  not  possible  to  effect  with  any  current  con- 
nected with  a  Kuhmkorff  coil.  (3)  The  general  diffusion 
of  this  current,  during  the  intervals  between  the  charge 
and  discharge  of  the  current,  are  greater  than  from  a 
current  administered  in  any  other  manner  with  safety  to 
the  patient.  (4)  The  current,  when  properly  applied,  is 
administered  to  the  patient  with  the  absence  of  any  dis- 
agreeable effects,  passing  in  and  out  of  his  body  without 
any  appreciable  sensation  except  the  moving  of  the  hair, 
the  vibratory  influence,  and  the  effects  of  muscular  con- 
traction. Care  should  be  exercised  to  administer  the 
treatment  with  the  metallic  electrode  next  to  the  skin  of 
the  patient,  an  intervening  ganuent  causing  disagree- 
able burning  sensations  due  to  the  passage  of  myriads  of 
short  sparks  through  the  fabric.  If  the  skin  of  the  i^a- 
tient  is  very  dry,  at  the  commencement  of  an  administra- 
tion, there  may  be  a  burning  sensation,  due  to  the  pas- 
sage of  short  sparks  through  the  dry  epidermis.  This 
is  easily  obviated  by  starting  the  administration  with  a 
short  spark-gap,  when  shortly  sufficient  secretion  will  be 
induced  to  moisten  the  integument,  or  by  first  moistening 
the  surface  beneath  the  electrode. 

The  physiological  effects  of  the  wave-current  suggest  a 


10  HIGH-POTENTIAL  CURRENTS 

very  wide  range  of  application  to  therapeutics.  In  the 
first  place,  the  current  is  absolutely  innocuous, — harmless 
to  the  patient, — which  makes  it  one  of  the  most  popular 
methods  of  applying  electricity.  This  will  be  easily  ex- 
plained when  we  realize  that  the  amperage  is  relatively 
so  small  that  the  possible  damage  to  the  patient  from  the 
quantity  of  current  is  reduced  to  a  minimum — and  that 
with  a  current  of  one  polarity,  though  surging  to  and  fro 
through  the  tissues,  the  electrolytic  action  is  practically 
nil.  Its  effect,  then,  is  purely  mechanical  with  the  added 
characteristics  of  electrical  discharges.  These  effects 
are  the  induction  of  contractions  which  restore  relaxed 
tissues  to  a  condition  of  tonicity,  in  which  condition  they 
will  persist  for  hours  after  the  administration. 

Upon  metabolism,  both  local  and  general,  the  actions 
of  this  current  are  remarkable.  The  vibratory  influence 
and  recurrent  intervals  of  contraction  induce  mechanic- 
ally an  activity  of  the  end  organs  beneath  the  electrode 
stimulating  secretion  and  excretion  and  tissue-building 
to  a  marked  degree,  and  without  harmful  effects.  Lo- 
cally, conditions  of  stasis  and  stagnation  are  overcome, 
a  local  tonic  condition  of  the  arterioles  is  induced,  pro- 
moting restoration  to  normal  conditions  where  stasis  has 
been  present.  These  effects  are  not  merely  superficial 
but  varied  in  their  depth  of  penetration  in  proportion  to 
the  amplitude  of  the  current,  which  is  varied  by  increas- 
ing or  slowing  the  speed  of  the  machine  and  by  lengthen- 
ing or  shortening  the  spark-gap.  The  physiological 
action,  other  things  being  equal,  will  depend  to  a  large 
extent  upon  the  character  of  the  underlying  subcutaneous 


THE  STxVTIC  WAVE-CURRENT  11 

tissues.  Layers  of  adipose  or  cellular  tissue,  owing  both 
to  the  fact  that  they  are  poor  conductors  and  muffle 
vibration,  tend  materially  to  interfere  with  tlic  ef- 
fects on  the  underlying  muscular  and  glandular  struc- 
tures. 

Muscular  contraction,  as  suggested,  may  be  induced  to 
varying  degrees  from  a  slight  vibratory  tremor  to  a  con- 
dition of  extreme  tetanus.  The  degree  of  contraction 
may  be  perfectly  controlled  by  the  operator,  by  varying 
the  length  of  the  spark-gap  and  to  some  extent  by  regulat- 
ing the  speed  of  the  machine. 

Vibration  of  a  distinctly  mechanical  character  is  in- 
duced in  consequence  of  the  tissue  contractions  and  by 
the  influence  of  surrounding  oppositely  charged  capac- 
ities, i.  e,,  the  walls  of  the  room  and  objects  surrounding 
the  insulated  platform,  and  may  be  intensified  either  by 
connecting  the  patient  with  any  external  insulated  capac- 
ity, as  a  plate  of  metal  suspended  upon  an  insulated 
stand  (see  Fig.  2),  or  even  by  movements  of  the  patient, 
as  of  the  extremities,  towards  an  oppositely  charged 
capacity,  as  the  opposite  pole  of  the  static  machine,  or 
walls  of  the  room.  The  vibratory  effect  is  undoubtedly 
also  influenced  by  the  sudden  impact  of  the  current  dis- 
charging against  the  resisting  skin,  and  the  impulses  of 
vibration  are  always  synchronous  with  the  discharge  at 
the  spark-gap.  The  depth  to  which  vibratory  impulses 
are  transmitted,  as  with  muscular  contraction,  will  be 
varied  by  altering  the  length  of  the  spark-gap,  and  the 
effect  produced  will  depend  largely  upon  the  conditions 
of  the  underlying  tissues, — a  thick  layer  of  fat  offering 


12 


HIGH-POTENTIAL  CURRENTS 


resistance  to  the  current,  and  limiting  the  effects  upon  the 
muscular  tissues. 

Contraction  of  cell  protoplasm  is  another  undoubted 
effect  produced  by  high-potential  discharges  at  the  site 
of  administration.  The  degree  or  extent  to  which  it  is 
possible  to  carry  this  effect  must  depend  upon  the  capac- 
ity for  diffusion  of  the  currents  employed.  Probably  no 
current  administered  in  therapeutics  so  universally  per- 
vades the  tissues  of  the  body  as  the  static  wave-current 


Fig.  2.     Showing  Arrangement  with  an  Insuhited  Capacity. 

I,  Insulated  Platform;  P,  Patient;  E,  Electrode;  E\  Second  Electrode; 

G,  Ground  Connection;  S.  G.,  Spark  Gap. 

administered  by  means  of  an  electrode  applied  to  a  small 
area.  It  must  immediately  pass  through  the  body  in 
every  direction  and  surround  the  whole  surface  of  the 
patient,  passing  in  nearly  straight  lines.  In  its  passage 
it  produces  universally  effects,  whatever  they  may  be, 
peculiar  to  electricity,  upon  the  tissues.  The  most  in- 
tense effect  of  the  current,  however,  upon  protoplasm 


THE  STATIC  WAVE-CURRENT  i3 

must  be  in  tlio  tissues  immediately  beneath  the  elec- 
trode. 

The  action  of  a  cur  rent  of  one  polarity  in  i)assiu<2: 
through  the  tissues  produces  effects  which  differ  from 
the  other  currents,  which  alternate  between  the  two  op- 
posite polarities.  During  the  to-and-fro  i)assage  of  the 
wave-current  all  cells  are  like  charged.  While  it  is  dif- 
ficult to  reconcile  the  idea  of  the  separation  of  cells  in 
tissues  which  are  relatively  homogeneous,  still  there  is 
reason  to  believe  that  the  cells,  on  account  of  this  condi- 
tion, are  temi)orarily  polarized,  assuming  different  sha])es 
and  acting  in  ways  which  arouse  activities  caj^able  of  i)ro- 
ducing  various  alterative  effects  upon  the  tissues  which 
they  compose. 

The  constitutional  effects  of  the  static  wave-current 
are  pronounced,  and  from  the  study  of  a  large  number  of 
clinical  results,  it  has  been  demonstrated  beyond  question 
to  be  of  great  utility  in  the  treatment  of  many  conditions. 
The  action  will  be  best  understood  from  the  foregoing 
description  of  the  modus  operandi  of  the  vibratory  and 
other  effects  of  the  current  as  described.  Undoubtedly 
these  constitutional  effects  are  largely  due  to  the  mechan- 
ical influences  of  the  discharges  and  peculiar  actions  of 
electricity  as  described. 

The  evidences  of  an  increase  of  general  metabolism  are 
marked  by  the  restoration  of  normal  functions,  notably 
the  activity  of  the  secretions,  followed  by  increased  ap- 
petite and  gain  in  weight  and  nmscular  strength,  when 
properly  associated  with  exercise  during  courses  of  treat- 
ment.   The  increased  elimination  of  solids  in  the  urine  in 


U  HIGH-POTENTIAL  CUEEENTS 

excess  of  tissue  combustion  is  demonstrated  in  patients 
who  have  been  inactive,  and  in  whom  the  general  nutri- 
tive functions  are  sluggish.  With  these  cases  it  is  the 
general  rule  that  during  the  first  weeks  of  treatment  the 
percentage  of  solids  in  the  urine  is  much  greater  than 
after  the  effects  of  poor  metabolism  have  been  eliminated. 
After  some  time  this  high  percentage  gradually  falls  off, 
but  still  a  larger  per  cent,  will  persist  than  that  present 
prior  to  the  institution  of  the  regular  administration  of 
the  current.  This  is  due  to  the  fact  that  the  general  activi- 
ties which  have  been  restored  produce  an  increased  oxida- 
tion of  tissue,  coincident  to  normal  healthy  metabolism. 

On  arterial  tension  there  will  be,  as  indicated  above,  an 
increase  locally  during  an  administration,  but  the  effect 
upon  the  general  system,  if  the  administration  is  pro- 
longed, is  to  lower  the  arterial  tension,  noticeable  in  the 
changed  character  of  the  pulse.  Coincident  with  this 
condition  will  be  a  lessened  frequency  and  fuller  rhythm 
of  the  heart's  action  and  the  normal  associated  changes 
in  respiration. 

Upon  the  nervous  st/stem  the  static  wave-current  pro- 
duces changes  in  condition  coincident  with  the  altered 
nutrition  and  changes  of  circulation,  as  well  as  markedly 
diminished  nervous  irritability,  and  associated  high  ten- 
sion, which  is  noticeable  in  the  relief  of  muscular  spasm 
and,  to  a  marked  degree,  of  nervous  tension. 

Heat  production  due  to  a  greater  degree  of  tissue  oxi- 
dation coincident  to  general  increase  of  metabolism  is  one 
of  the  remarkable  effects  of  this  modality,  and  one  of  the 
strongest  evidences  of  its  positive  action  upon  a  human 


THE  STATIC  WAVE-CURRENT  15 

organism.  In  order  to  demonstrate  this  fact,  which  the 
writer  had  always  observed  to  be  pronounced  when  ad- 
ministering the  current  to  patients  for  periods  of  twenty 
minutes  to  one-half  hour,  he  made  the  following  experi- 
ment: A  patient  was  placed  upon  the  static  platform  in 
a  room  having  a  temperature  of  30°  F,  When  the  ])a- 
tient  seated  herself  she  was  feeling  chilled  and  her  feet 
were  cold.  A  large  metal  electrode  was  placed  over  the 
liver  and  solar  plexus  and  the  wave-current  was  admin- 
istered in  the  usual  manner,  employing  a  spark-gap  of 
four  or  five  inches ;  at  the  end  of  ten  minutes,  the  patient 
was  feeling  no  discomfort,  and  at  the  end  of  twenty  min- 
utes was  thoroughly  warmed  and  comfortable.  This 
experiment  practically  demonstrated  the  energetic  effects 
of  this  current  upon  tissue  metabolism  and  heat  produc- 
tion. 

Upon  the  secretions,  the  action  of  the  wave-current 
is  very  pronounced.  During  the  first  administrations, 
when  instituting  a  series  of  treatments  of  a  patient  hav- 
ing general  sluggishness  of  the  functions  of  the  skin, 
there  may  be  little  or  no  secretion  of  perspiration  during 
the  first  few  treatments.  There  will,  however,  be  a 
marked  increase  of  the  perspiration  and  other  secretions 
in  most  such  cases  after  several  administrations.  The 
evidence  of  the  increased  secretion  of  other  glands,  which 
as  a  rule  resume  coincidently  with  return  of  the  secretion 
of  perspiration,  is  demonstrated  by  the  better  perform- 
ance of  the  functions  upon  which  they  depend. 

Tt  is  easily  shown  with  a  patient  whose  digestion  is 
impaired  by  giving  a  test  breakfast,  and  two  hours  after 


16  HIGH-POTENTIAL  CURRENTS 

the  meal  taking  the  contents  of  the  stomach  for  examina- 
tion. On  the  following  day  give  another  test  meal  and 
at  the  expiration  of  one-half  hour  apply  a  flat  metal 
electrode  over  the  epigastrimn,  and  administer  the  wave- 
current  at  this  site  for  fifteen  or  twenty  minutes.  Two 
hours  after  taking  the  meal  withdraw  it  for  examination 
and  compare  them.  Whereas  the  second  meal  will 
be  well  digested,  the  first  will  be  found  to  be  not  nearly 
so  completely  digested  unless  the  patient's  digestion  is 
normal.  It  is  also  observed  with  patients  in  whom  the 
secretion  of  the  liver  has  been  pronouncedly  deficient, 
that  when  the  wave-current  is  applied  over  the  organ, 
within  a  few  days  there  will  be  marked  evidence  of  an  in- 
creased functional  activity.  The  same  is  true  of  the  kid- 
neys, pancreas,  and  intestinal  secretions.  These  results 
demonstrate  the  great  utility  of  this  current  upon  condi- 
tions in  which  the  functions  are  inactive. 

There  are  no  evidences  of  fatigue  or  over-stimulation 
of  the  organic  structures  when  administrations  are  given 
in  normal  individuals  for  from  twenty  to  thirty  minutes, 
but,  on  the  contrary,  increased  functional  activity,  and 
in  congested  conditions  a  degree  of  inhibition  is  in- 
duced which  deserves  consideration  from  all  earnest  ob- 
servers. A  very  prolonged  administration,  over  forty 
minutes,  may  however  produce  a  feeling  of  fatigue,  which 
is  always  followed  after  a  brief  rest  by  a  sense  of  well- 
being.  No  effect  is  produced  that  can  be  considered  in- 
jurious even  after  very  prolonged  administrations. 

A  wide  range  of  therapeutic  indications  for  the  use  of 
the  wave-current  is  suggested  by  an  increasing  evidence 


THE  STxVTTC  WAVE-CURRENT  17 

of  its  worth,  and  probably  no  one  therapeutic  agent  to-day 
occupies  a  field  of  usefulness  so  large,  especially  in  condi- 
tions of  local  congestion  and  in  its  beneficial  effects  upon 
local  and  general  metabolism.  It  has  been  frecjuently 
suggested  to  the  writer  that  in  his  previous  work  on 
"  Electro-Static  Modes  of  Application  and  Therapeu- 
tics "  he  has  not  been  sufficiently  full  in  the  explanation 
of  this  valuable  modality,  which  is  the  apology  for  devot- 
ing so  much  space  to  its  application  here. 

The  indications  for  its  employment  in  therapeutics,  as 
suggested  from  the  foregoing,  are  as  follows:  (1)  the  re- 
lief of  k)cal  congestion  and  induration,  and  tlic  elimina- 
tion of  inflammatory  exudates;  (2)  the  relief  of  pain, 
which  is  usually  coincident  with  the  effect  upon  the  pre- 
ceding conditions;  (3)  to  relieve  muscular  spasm;  (4) 
to  lessen  nervous  irritability;  (5)  to  correct  errors  of 
metabolism;  (6)  to  generally  increase  functional  activity, 
(a)  by  its  action  upon  the  secretory  and  excretory  func- 
tions, (b)  by  the  restoration  of  local  muscular  tone, 
thereby  relieving  atony,  (c)  by  overcoming  nervous  and 
muscular  inertia. 

Upon  congestion  and  local  hyperemia,  as  present  either 
with  acute  processes  or  conditions  of  functional  inactivity 
associated  with  sluggish  metabolism,  the  effect  is  most 
pronounced.  Probably  muscular  and  tissue  contraction 
and  the  induced  activity  of  cell  j^rotoplasm  excited  by  the 
action  of  this  current  by  overcoming  stasis,  are  especially 
effective  in  relieving  congested  and  hyperaemic  condi- 
tions. It  induces  with  the  recurrent  contractions  and 
relaxations   an  expression  of  the  fluids  and   increased 


18  HIGH-POTENTIAL  CURRENTS 

activity,  with  the  re-establishment  of  circulation  in  the 
tissues  coincident  with  an  increase  locally  of  the  meta- 
bolic functions  of  elimination  and  repair.  The  best  re- 
sults are  obtained  in  these  conditions  by  the  employment 
of  low  rates  of  frequency.  Probably  discharges  of  one 
hundred  and  fifty  to  three  hundred  are  the  limit  at  which 
the  interruptions  should  be  permitted  for  the  best  thera- 
peutic results  in  the  treatment  of  inflammatory  proc- 
esses. It  is  appreciated  by  all  who  are  familiar  with 
the  modus  operandi  of  this  current,  in  the  conditions 
under  consideration,  that  periods  of  rest  between  the  in- 
tervals of  contraction  are  essential  to  the  attainment  of 
the  best  results. 

When  we  appreciate  that  congestions  and  hyperaemic 
conditions,  associated  with  pressure  upon  the  venous  cir- 
culation,— acute  and  subacute  congestions, — are  the  most 
common  concomitants  or  causes  of  diseased  conditions, 
we  must  admit  the  indications  for  the  emplojTuent  of  cur- 
rents of  moderate  frequency  producing  the  mechanical 
effects  of  vibration  and  recurrent  contractions.  It  is  a 
draining  process,  the  recurrent  vis-a-tergo  exciting  activi- 
ties that  are  invaluable  in  the  treatment  of  inflammatory 
conditions.  When  the  fact  is  realized  that  few  diseases 
with  pain,  muscular  spasm,  functional  neurosis,  or  other 
pathological  conditions  are  not  induced  by  inflammatory 
processes,  the  importance  of  the  recognition  of  currents 
such  as  the  wave-current  and  other  modalities  which  in- 
duce resumption  of  circulatory  drainage  and  repair,  must 
be  appreciated.  A  local  lesion  should  be  suspected  and 
its  character  considered  in  all  painful  and  functional  de- 


THE  STATIC  WAVE-CURRENT  19 

rangements,  for  in  most  instances  the  conditions  may  be 
referred  to  a  coexisting  inflammation.  It  matters  not 
with  the  employment  of  tlir  wave-current  whether  the 
congestion  or  hyperaemia  is  located  beneath  superficial 
muscular  structures,  as  in  sciatic  neuritis,  or  in  the 
deeper  viscus  or  great  glands  of  the  body,  under  proper 
treatment.  The  am})litude  of  the  oscillations  of  this  cur- 
rent, when  induced  by  a  machine  of  proper  capacity,  is 
sutKcient  to  penetrate  remote  parts  and  influence  the 
denser,  deeper  tissues  of  the  human  organism  except  in 
very  obese  subjects.  The  author's  familiarity  with  the 
work  of  many  who  have  employed  this  modality  with  dif- 
ferent measures  of  success,  induces  him  to  urge  a  more 
energetic  and  intelligent  emplojTuent  of  the  wave-cur- 
rent; for  those  who  have  not  succeeded  as  they  should, 
have  employed  it  in  an  inefficient  manner.  The  following 
rules  of  dosage,  if  carefully  followed,  are  a  sufficient 
guide  for  its  successful  administration. 

I.  When  employing  the  eurrent  for  the  relief  of  aeute 
local  congestion,  over  the  inflammatory  area  at  the  begin- 
ning of  the  first  application,  with  but  a  short  spark-gap, 
severe  pain  will  be  produced,  which  is  caused  by  the  con- 
traction of  the  muscular  structures  including  the  muscular 
ccats  of  the  arterioles  in  the  inflammatory  area,  pro- 
ducing pain  by  pressure.  In  a  few  moments,  however,  as 
the  fluids  are  expelled,  a  longer  spark-gap  can  be  adminis- 
tered with  not  greater  discomfort  than  was  at  first  ex- 
perienced. In  this  way,  liy  gradually  lengthening  the 
spark-gap,  and  thereby  increasing  the  amplitude  and 
deeper  penetration  of  the  current,  the  more  remote  tis- 


20  HIGH-POTENTIAL  CURRENTS 

sues  are  reached,  and  the  entire  congested  region  more  or 
less  completely  drained  and  the  tissues  left  in  a  state  of 
tonic  contraction.  The  length  of  spark  allowed  to  pass 
at  the  spark-gap  during  an  administration  will  depend 
therefore  largely  upon  the  degree  of  discomfort  produced 
at  the  time  of  the  application  and  should  be  lengthened  as 
the  patient,  tolerating  a  moderate  degree  of  pain,  per- 
mits it. 

II.  In  the  treatment  of  deep-seated  conditions ,  where 
the  congestion  is  not  sufficiently  intense  to  cause  pain  in 
connection  with  the  administration  of  the  current,  and  in 
atonic  conditions,  the  guide  as  to  dosage  will  be  the  de- 
gree of  muscular  contraction  produced;  avoiding  the  in- 
duction of  an  unpleasant  or  tetanic  muscular  contraction, 
but  crowding  it  up  to  the  limit  at  which  this  effect  will 
begin  to  be  produced. 

It  must  also  be  remembered  that  an  electrode  large 
enough  to  cover  considerable  surface  relatively  diffuses 
the  current,  so  that,  when  it  is  desired  to  get  an  intense 
local  vibratory  effect  upon  some  lazy  viscus,  it  will  be 
necessary  to  make  the  electrode  small  enough  that  the 
maximum  spark-gap  to  be  obtained  will  produce  an 
intense  local  effect.  Many  in  the  past  have  been  neg- 
ligent in  giving  the  proper  amplitude  and  intensity  with 
the  administration  because  of  the  noise  of  the  discharge 
at  the  spark-gap  or  want  of  a  proper  appreciation  of  the 
requirements.  The  unfortunate  disadvantage  of  the 
noise  may  be  overcome  by  a  properly  constructed  muffler, 
which  will  relieve  this  unsatisfactory  feature  of  the  ad- 
ministration (see  Fig.  3).     In  the  writer's  experience, 


THE  STATIC  WAVE-CUKRENT 


21 


however,  uervous  patients  tolerate  the  noise  much  better 
than  some  physicians  who  treat  them. 

These  observations  on  dosage  apply  not  only  to  the  ad- 
ministrations to  inflammatory  conditions,  but  to  the  ap- 
plications of  the  current  in  all  cases.    It  should  be  farther 


Fig.  3.     Glnss  Muffler. 

added  that  the  wave-current  cannot  be  used  entirely  to 
the  exclusion  of  the  more  rigorous  static  modality, — 
sparks.  In  some  cases,  as  of  deep-seated  congestion  and 
conditions  associated  with  the  presence  of  inflammatory 
exudates  and  when  it  is  desirable  to  get  a  i)rompt  re- 
sponse of  the  perspiratory  function,  the  application  of 
sparks  and  the  superficial  action  of  friction  sparks  will 
afford  an  additional  benefit  to  the  condition. 

Attention  must  be  called  to  the  fact  that  there  are  cer- 
tain inflammatory  ])rocesses  and  conditions  duo  to  or 
associated  with  the  i)resence  of  germs  in  which  those 
static  modalities  will  fail  and  are  also  contra-indicated, 
that  is,  in  the  treatment  of  local  septic  processes  where 
pus  is  present,  or  where  some  other  germ  process  is 
present  beneath  the  integument.  In  such  cases  no  static 
modality  has  proved  efficacious.    When  pus  is  walled  off 


22  HIGH-POTENTIAL  CURRENTS 

by  surrounding  induration,  stasis  is  a  protection  against 
the  extension  of  infection  and  must  not  be  disturbed  by 
the  wave-current  or  any  influence  which  will  remove  the 
wall  of  safety. 

In  syphilitic  processes,  gonorrheal  rheumatism,  tuber- 
cular processes,  and  infectious  disease  this  modality  fails, 
but  will  be  found  a  valuable  aid  to  diagnosis  by  exclusion 
in  tubercular  arthritis  and  gonorrheal  rheumatism.  If 
success  follows  the  administration,  such  processes  may  be 
eliminated,  as  has  been  the  writer's  experience  with 
tubercular  joint  affections.  In  all  other  than  infected 
conditions  positively  beneficial  effects  are  certain  to 
result. 

Pain  is  probably  relieved  by  this  and  the  other  high- 
potential  modalities  which  produce  perceptible  muscular 
contraction  as  by  no  other  agent  except  morphine,  because 
the  presence  and  pressure  of  local  congestion  are  relieved. 
In  these  cases,  the  relief  is  associated  with  a  curative 
process  due  to  the  removal  of  inflammation;  first, by  over- 
coming local  stasis,  and,  second,  by  the  removal  of  in- 
flammatory exudates,  while  with  anodynes  the  relief  is 
but  temporary  and  never  curative.  The  writer's  ob- 
servation in  the  treatment  of  painful  neuroses  has  led  him 
to  believe  that  many  of  the  pains  of  so-called  ''  neural- 
gia "  are  not  reflex  but  associated  with  remote  inflam- 
matory conditions.  Pains,  however,  due  to  low  grades 
of  toxaemia  arising  from  improper  evacuation  of  the 
alimentary  tract,  imperfect  metabolism,  or  malarial 
poisoning,  cannot  be  strictly  referred  to  inflammatory 
conditions.      Such  pains,  however,  are  remarkably  re- 


THE  STATIC  WAVE-CURRENT  23 

lieved  by  overcoming  the  conditions  which  caused  them; 
for  the  relief  of  wliich,  except  mahirial  cases,  i)robably  no 
agent  will  contribute  more  than  the  static  wave-current. 

Muscular  spasms  or  contractions  of  the  skeletal  mus- 
cles are  certain  to  occur  in  connection  with  inflammatory 
conditions  of  the  joints,  disappearing  upon  removal  of  the 
causative  conditions.  Contractions,  however,  of  cerebral 
origin,  such  as  those  of  atlietosis,  do  not  respond  to  treat- 
ment. Many  of  the  contractures  associated  with  the 
functional  neuroses,  as  of  the  uterus  in  cases  of  dys- 
menorrhea, respond  very  promptly  to  the  administration 
of  the  wave-current,  vacuum  tubes,  or  static  sparks. 

In  conditions  of  nervous  irritability  the  origin  of  the 
trouble  is  found  usually  to  be  an  inflammation  located 
somewhere  in  the  organism.  It  is  therefore  necessary 
to  carefully  diagnose  the  original  condition  and  then 
make  the  appropriate  administration.  If  this  is  done  in 
a  thorouglily  systematic  manner,  there  will  be  little  dif- 
ficulty in  relieving  most  of  the  functional  and  many 
organic  nervous  conditions. 

General  errors  in  metaholistn  whenever  present,  either 
local  or  not,  unless  some  organic  condition  precludes  the 
possibility  of  restoring  the  normal  condition,  may  be 
greatly  relieved  by  these  modalities.  It  may  be  wise, 
however,  to  combine  with  it  in  many  cases  the  administra- 
tions of  dry  heat,  light,  or  mechanical  vibration.  If,  how- 
ever, but  one  method  of  treatment  were  to  be  used  in  the 
treatment  of  sluggish  conditions,  there  is  no  modality 
that  oifers  so  much  for  their  relief  as  the  static  wave- 
current.    For  the  treatment  of  these  affections,  the  ad- 


24  HIGH-POTENTIAL  CURRENTS 

ministration  should  always  be  made  over  the  organs 
which  are  the  seat  of  the  difficulty,  or  in  doubtful  cases 
it  may  be  applied  with  comparative  uniformity  over  the 
abdomen,  employing  an  electrode  about  five  by  eight 
inches  in  size,  placing  it  over  the  anterior  portion  of  the 
liver,  the  epigastrium,  solar  plexus,  and  pyloric  end  of 
the  stomach  and  pancreas,  with  a  view  to  effecting  an 
active  metabolism  and  improving  the  nutritive  functions. 

Activity  of  special  functions  may  be  gradually  ac- 
celerated by  this  energetic  modality,  bearing  in  mind  that 
wherever  muscular  structures  are  present  in  glands, 
arteries,  and  other  structures,  the  effect  of  inducing 
muscular  and  other  tissue  contraction,  causing  an  ex- 
pulsion of  fluidis  locally,  and  coincidentally  InK^reases  the 
general  activity  of  the  functions  of  the  body,  especially 
of  those  organs  immediately  beneath  the  electrode.  Un- 
der this  heading  will  be  included  an  increase  of  secretion 
and  excretion,  restoration  of  normal  blood  circulation, 
relief  of  muscular  atony,  and  the  restoration  of  tone  to 
the  structures  of  the  body. 

Conditions  of  nervous  inertia  or  general  inactivity  of 
function,  so  common  in  persons  who  lead  sedentary  lives 
without  sufficient  muscular  exercise,  will  be  generally 
overcome  and  their  lives  lengthened.  These  observations, 
which  have  been  demonstrated  by  the  therapeutic  results 
in  the  treatment  of  hundreds  of  cases  in  the  clinics  and 
practice  of  the  writer,  are  sufficient  to  warrant  the  gen- 
eral adoption  of  the  wave-current  and  other  high- 
potential  modalities,  especially  those  which  produce  a 
well-marked  degree  of  perceptible  tissue  contraction. 


CHAPTER  III 

THE    STATIC    INDUCED    CURRENT 

This  current,  the  oldest  of  the  high-freqnency  currents, 
"vvas  discovered  by  Dr.  Wm.  J.  Morton  of  New  York.  It 
is  described  by  the  author  as  follows: 

'*  From  the  earliest  medical  electrifications  by  the  Abbe 
Nollet  in  1734 — we  become  familiar  with  the  breeze, 
spray,  sparks,  and  shock,  but  no  mention  is  made  of  a  cur- 
rent disassociated  from  the  spark  delivered  to  the  person, 
nor  prior  to  my  own  had  any  electrodes  been  shown  by 
which  a  current,  except  in  spark  form,  could  be  delivered 
from  a  Holtz  or  any  other  influence  machine.  When,  in 
general,  nerve  and  muscle  reactions  were  spoken  and  writ- 
ten of,  reference  was  had  to  galvanic  and  to  faradic  cur- 
rents from  coils  and  voltaic  cells,  or  from  coils  and 
magnets,  but  not  to  any  current  derivable  from  frictional 
electricity.  The  sj)ark  and  static  electricity  had  become 
sjTionymous  terms.  That  no  one  during  one  hundred  and 
fifty  years  should  have  sought  out  the  kinetic  or  current 
feature  of  the  static  discharge  (in  other  than  spark  form) 
and  harnessed  it  to  an  electrode  capable  of  bringing  it 
into  use,  seems  most  remarkable.  .  .  . 

"  My  new  system,  published  and  unpublished,  com- 
prises the  development  by  an  influence  machine  of  a 
rapidly  interrupted  and  graduated  current,  by  means  of 
a  circuit-breaker,  introduced  into  a  circuit  with  and  with- 

25 


26  HIGH-POTENTIAL  CURRENTS 

out  condensers,  and  in  the  medical  applications  of  this 
current  without  and  within  the  human  body  by  moistened 
sponge  or  other  electrodes,  just  as  in  the  case  of  the 
ordinary  galvanic  and  faradic  currents. 

"  It  involves  the  removal  of  the  spark,  in  itself  more 
or  less  disagreeable  and  painful  and  often  difficult  to 
localize,  especially  about  the  face  and  neck,  away  from 
the  patient's  body,  and  yet  retaining  all  the  physiological 
effects  of  the  kinetic  or  current  part  of  the  circuit.  The 
spark  is  no  longer  a  direct  feature  of  the  administration ; 
it  occurs  at  some  distant  part  of  the  necessarily  closed 
circuit,  and  in  modified  form  now  becomes  mainly  a 
regulator  for  timing  the  discharge  of  the  equalizing 
potentials. 

''  The  circuit-breaker  is  a  pair  of  adjustable  metallic 
ball  electrodes,  introduced  at  any  point  of  the  circuit,  hav- 
ing a  narrow  air  space  between  the  balls;  the  circuit 
makes  when  a  small  spark  overcomes  the  resistance  of 
the  air,  and  breaks  when  it  fails  to  do  so,  and  the  current 
is  due  to  rapidly  successive  equalizations  of  the  differ- 
ences of  potential  of  opposite  charged  condensers,  with 
either  the  prime  conductors  or  the  addition  of  Leyden 
jars.    .    .    . 

' '  Accepting  the  fact  that  the  rapidity  of  succession  of 
impulses  of  the  new  current  is  in  itself  sufficient  to  pro- 
duce a  steady  circuit,  we  may  now  go  a  step  further  and 
say  that  each  impulse  in  itself  consists  of  a  vast  number 
and  range  of  oscillations  or  alternations  (of  one  hundred 
millions  per  second),  and,  putting  all  the  facts  together, 
we  may  doubtless  willingly  concede  that  a  current  must 


THE  STATIC  INDUCED  CURRENT 


:n 


possess    eciually    i)Ositive    and    differiug    })hysiological 
properties."    .    .    . 

"  Id  bis  earliest  publication  ujmn  tbis  subject  appear 
tbe  following  for  i)bysical  results  tben  noted.  Tbe  event 
has  sbown  tbat  many  of  tbese  were  tben  imperfectly 
understood  and  ai>i)reciated,  but  tbe  question  before  us  is 
wbetber  or  not  these  observed  results  were  in  fact  novel." 

1.  ''  By  means  of  the  spark-gap  at  the  discharging  rod, 
the  imperceptible  physical  effects  *  may  be  regulated  to 
a  nicety,'  "  from  an  almost  imperceptible  tingle  up  to  the 
extreme  rigid  flexion  of  the  arms. 

2.  '*  Tbe  effect  is  soft  and  agreeable  and  accompanied 
by  no  shock,"  while  the  inner  coating  of  tbe  jars  gives  a 
series  of  discharges  which,  even  when  slight,  are  ''  too 
painful  to  be  borne." 

3.  "  Capable  of  causing  physiological  tetanus,"  while  a 
connection  between  the  inner  coating  of  the  jars  "  in 
silent  current  forms  produces  no  muscular  contractions 
or  sensations  of  any  kind." 

4.  ''  When  compared  with  the  galvano — or  magneto — 
induced  current,  both  produce  more  efficient  contractions 
and  give  less  pain  to  the  patient,  when  pain  would  be 
produced  by  any  of  the  three. ' ' 

5.  "  Renders  a  static  machine  capable  of  producing 
all  the  effects  of  faradism,  doing  *  all  the  work  of  the  best 
faradic  machines  '  in  addition  to  the  ordinary  static 
effects.      *  In    its   general   cbaracteristics  '   tliis   current  i 

*  cannot  be  distinguished  from  the  ordinary  faradic  cur-  i  f 

rent.'"*  i 

*  Fxfrart  from  Rppnrt  of  the  Committpr  on  tlie  Static  Currents  of  the  Ameri- 
can Electro  Therapeutic  Association. 


28  HIGH-POTENTIAL  CURRENTS 

The  acknowledgment  of  Morton's  priority  in  the  dis- 
covery of  this  current  has  been  recognized  by  all  recent 
writers  upon  the  subject  of  high-frequency  currents,  in- 
cluding Tripier,  Bourgoni,  Leduc,  Paschles,  Ranney, 
Williams,  Weil,  Bordier,  Freund,  Jenks,  Thompson, 
Herdman,  and  others. 

The  footnote  from  Freund  *  explains  itself. 

The  following  description  of  the  method  of  employing 
the  current  and  its  physics  by  the  Committee  on  Cur- 
rent Classification  and  Nomenclature  was  published 
in  the  Journal  of  Advanced  Therapeutics  for  January, 
1904: 

"  The  patient  is  directly  in  circuit  with  the  outside 
coatings  of  two  Leyden  jar  condensers  in  series.  The 
spark-gap  and  machines  are  in  multiple  with  each  other. 
With  the  patient  included  in  circuit  in  the  manner  shown 
in  the  diagram  we  do  not  know  the  value  of  the  inductance 
and  resistance  offered  by  him.  The  arrangement  of  two 
condensers  of  small  capacity  is  conducive  to  the  produc- 
tion of  oscillatory  currents  of  relatively  high  frequency, 
and  such  currents  will  be  produced  if  the  patient  offers  a 

*  Extract  from  "  Radio-Therapy,"  Freund  :  "  In  the  year  1881  Morton  de- 
scribed a  method  of  using  electricity  for  the  local  treatment  of  muscle  and 
nerve  disorders.  He  brought  the  terminals  of  the  discharger  of  an  electrical 
machine  so  near  together  that  sparks  passed  between  them.  He  then  put  his 
patient  in  the  circuit  connecting  the  tin-foils  of  the  condensers.  Morton  was 
the  first  to  produce  by  means  of  this  arrangement  and  to  therapeutically  apply 
high-frequency  currents,  for  he  had  used  the  oscillating  character  of  the  con- 
denser-discharge to  increase  the  frequency  of  an  alternating  current.  The  con- 
densers were  charged  in  this  case  through  an  induction  apparatus.  Morton's 
high-tension  oscillating  currents  have  been  used  by  Leduc  and  F.  Winkler  in 
similar  affections,  and,  of  course,  with  results  similar  to  those  produced  by 
other  forms  of  high-frequency  apparatus." 


THE  STATIC  INDUCED  CURRENT 


29 


sufficiently  low  resistance  and  inductance.  In  the  July, 
1903,  issue  of  Medical  Electrology  and  Radiology,  Dr. 
Manders  expressed  the  opinion  that  the  impedance  (sum 
of  the  resistance  and  inductance)  of  the  circuit  including 
the  patient  may  be  so  great  as  to  render  the  current 
unidirectional  by  damping  out  the  oscillations  which  the 
condensers  of  small  capacity  tend  to  ])roduce." 

"  The  term  *  static-induced  '  apj)lied  by  Dr.  W.  J.  Mor- 
ton to  this  arrangement,  made  by  him  in  1881,  is  techni- 


Fl'i.  4.     Amiiguineut  for  tliu  .*?l;ilic  liiducocl  C'urifUt. 

cally  accurate  (Report  of  this  Committee,  see  Journal 
of  Advanced  Therapeutics,  Vol.  XXII,  Jan.,  1904,  j).  29). 
This  term  expresses  the  arrangement  by  which,  as  is  now 
generally  understood  and  conceded,  currents  of  the  char- 
acter technically  known  as  high-frequency  currents  were 
first  produced,  and  ajiplied  to  therapeutic  purposes  in 
such  a  way  as  to  be  tolerable  to  the  patient;  and  on  the 


30  HIGH-POTENTIAL  CURRENTS 

basis  of  which  arrangement  some  subsequent  arrange- 
ments are  founded;  for  example,  that  of  d'Arsonval,  also 
those  more  recently  devised  by  Dr.  Morton. ' ' 

The  physiological  actions  of  the  static  induced  current 
include  the  actions  described  by  Dr.  Morton  in  his  de- 
scription of  the  current  as  given  above.  A  wider  concep- 
tion of  the  effects  of  the  current  characteristic  of  the 
action  of  the  high-potential  discharges  in  the  production 
of  tissue  contraction,  however,  widely  enlarges  the  scope 
of  its  application.  In  this  respect  it  is  analogous  to  the 
local  actions  of  the  wave-current  as  given  in  the  preceding 
chapter.  An  alternating  current  employing  two  metal 
electrodes,  however,  produces  chiefly  local  effects — the 
electrical  and  mechanical  effects  upon  the  tissues  beneath 
the  electrodes  and  in  the  interpolar  region  between  the 
two  surfaces  covered.  The  local  actions,  however,  of  this 
current  are  to  effect  in  the  same  manner  the  relief  of  local 
stasis  and  sluggish  metabolism  as  those  of  the  wave- 
current. 

The  static  induced  current,  however,  possesses  certain 
advantages  over  the  wave-current  which  will  arise  in  the 
experience  of  every  practitioner. 

During  periods  of  humidity,  when  it  is  impossible  to 
administer  a  spark-gap  of  sufficient  length  to  produce  the 
indicated  local  vibratory  effect  beneath  an  electrode, 
necessary  to  overcome  local  congestion  with  the  wave-cur- 
rent, the  static  induced  current  having  a  more  limited  and 
localized  field  of  action,  and  the  added  intensity  of  the 
characteristic  condenser  discharges,  produce  with  a 
shorter  spark-gap  a  much  more  profound  local  effect. 


THE  STATIC  INDUCED  CURRENT  31 

It  is  necessary,  when  employing  this  current,  to  make 
the  applications  to  two  different  parts  of  the  body.  One 
may  be  placed  over  some  i)art  as  an  indifferent  electrode, 
or  may  be  valuable  in  the  treatment  of  two  parts,  as  both 
knees,  in  a  very  stout  i)atient.  In  such  a  case  an  intense 
local  effect  will  be  demanded. 

The  application  of  two  electrodes  may  also  be  of  partic- 
ular value  in  the  treatment  of  a  local  inflammatory  con- 
dition in  one  part  and  at  the  same  time  an  additional  ap- 
plication over  some  other  part  of  the  body  where  the 
functions  are  particularly  sluggish,  as  over  the  liver  or 
intestinal  tract. 

The  static  induced  current  may  be  used  with  two  glass 
vacuum  electrodes  applied  over  two  different  parts  of 
the  same  patient  or  to  two  patients  at  the  same  time, 
or  with  the  vacuum  tube  at  one  part  of  the  body  and  a 
metal  electrode  on  another  part.  This  plan  of  treatment 
will  be  found  very  convenient  in  the  treatment  of  certain 
pelvic  conditions  where  it  is  desirable  to  employ  the  metal 
electrode  over  the  abdomen  and  the  glass  tube  internally. 
(See  Plate  I,  Frontispiece.) 

Whenever  two  electrodes  arc  a]iplied  at  different  parts 
of  the  body  the  local  effect  may  be  disagreeably  un- 
])leasant  over  one  surface  to  produce  sufficiently  energetic 
effects  over  another.  This  may  be  easily  regulated  either 
by  regulating  the  size  of  the  metal  electrode  or  by  ])lacing 
a  larger-sized  Leyden  jar  in  connection  with  the  machine 
on  tlie  side  where  a  more  energetic  action  is  indicated. 
By  this  means,  with  the  three  usual  sizes  of  Leyden  jars 
that  are  provided  with  the  static  machine,  it  is  possible  to 


32  HIGH-POTENTIAL  CURRENTS 

make  very  fine  adjustments  of  the  effects  of  the  current 
in  connection  with  each  electrode.     (See  Plate  I.) 

It  must  be  borne  in  mind  that  the  static  induced  current, 
as  indicated  above,  does  not  produce  the  constitutional 
effect  upon  the  organism  that  is  produced  by  the  wave- 
current.  It  is  not  therefore  indicated,  except  when  neces- 
sary on  account  of  atmospheric  humidity,  in  cases  for 
which  there  is  no  special  indication  for  the  improvement 
of  constitutional  conditions,  or  when  time  may  be  saved 
by  treating  two  parts  requiring  an  application  of  too 
great  intensity  to  be  treated  at  one  time  with  the  wave- 
current. 


CHAPTER  IV 

DISRUPTIVE    DISCHAEGES,    SPARKS 

The  high-potential  spark  discharged  either  with  or 
without  the  iuterveution  of  a  resonator  in  connection 
with  a  coil  or  static  machine,  is  one  of  the  most  valuable 
of  the  modalities  employed  in  therapeutics;  from  the 
entire  surface  of  a  patient  to  the  point  of  discharge  the 
currents  focus  and  escape,  forming  a  vortex,  as  it  were, 
leaving  the  tissues  behind  in  a  state  of  perturbation.  Of 
this  method  of  administration,  but  two  modes,  the  usual 
ones,  deserve  consideration, — tlie  indirect  spark  and  the 
resonator  spark. 

The  indirect  spark  is  derived  only  from  the  static 
machine  and  may  be  described  as  follows :  The  patient  is 
seated  upon  the  platform,  which  is  connected  usually  by  a 
shepherd's  crook  from  a  metal  ])late  placed  upon  the  ])lat- 
fonn  beneath  the  chair  to  the  positive  side  of  the  machine 
(the  negative  connection  is  preferred  by  some  oper- 
ators). The  opposite  side  should  be  grounded  by  means 
of  a  metallic  connection  with  moist  earth.  (See  Fig.  5.) 
The  operating  ball  is  connected  from  the  screw  eye  of  the 
metallic  ])ortion  with  another  chain  or  other  metallic  con- 
nection also  to  the  earth.  With  this  ])rovision  it  is  not 
necessary  that  the  operator  be  insulated  from  the  metal 
connection,  as  no  effect  is  i)roduced  upon  him  when  ad- 
ministering the  snark  if  the  connection  to  the  earth  is 

83 


34 


HIGH-POTENTIAL  CURRENTS 


direct,  as  no  appreciable  part  of  the  current  will  leave  tlie 
better  conductor  to  the  earth  for  a  poor  one,  as  the 
operator  standing  upon  the  floor.  It  is  customary  there- 
fore for  the  operator  to  hold  the  chain  in  his  hand  against 
the  handle  of  the  ball  and  at  the  same  time,  with  the  other 


Fig.  5.     Arrangement  for  Indirect  Spark. 

hand,  hold  it  in  such  a  manner  that  it  will  not  be  con- 
stantly thrown  to  and  fro  against  the  platform  or  the 
patient,  interfering  with  the  administration.  The  sparks 
may  be  administered  of  any  desired  length  according  to 
the  indications — the  longer  spark  for  the  deeper  perturb- 
atory  effect  upon  the  tissues.  To  regulate  the  length  of 
the  spark  either  move  the  shepherd's  crook  to  the  rear  end 
of  the  platform,  remove  the  metal  plate  which  acts  as  a 
condenser,  slow  the  speed  of  the  machine,  thereby  dimin- 
ishing the  output,  or  close  the  discharging  rods  so  that  the 


DISKrPTIVE  Dl^;OHAR(iES,  SPAKKS  35 

balls  are  si-parated  to  a  ilit^iaiice  a  little  j;i'ealer  than  the 
length  of  the  spark  desired.  By  these  means  we  will  de- 
termine the  potent idl  of  deticcri/,  or  llic  l('ii«:tli  of  si)ark 
[xjssible  to  administer,  which  slionhl  always  he  regulated 
to  the  depth  of  tissue  which  it  is  desirable  to  affect.  The 
length  of  si)ark  should  vary  usually  from  tme-half  inch 
for  aj>j)licatlon  to  the  tingei-s  to  lour  or  live  inches  over 
the  glutei  and  IkuU  of  the  patient,  according  to  the  depth 
of  the  tissue,  taking  into  account  also  the  amount  of 
adipose  overlying  the  muscular  structures,  the  latter  act- 
ing as  a  resistance  and  at  the  same  time  breaking  up  !he 
vibratory  effect  and  the  influence  of  contraction  upon  the 
structures  affected. 

A  spark  director  designed  by  the  author.  Fig.  0,  is  a 


Fig.  6.     Author's  Spark  Director. 

practical  device  for  a})plyiug  sparks.  It  is  provided  with 
a  long  vulcanite  or  glass  handle  and  two  terminals  of 
metal  to  be  adapted  to  different  surfaces  and  to  admit 
of  a  varying  degree  of  concentration  or  disi>ersion  itf  the 
current  to  larger  or  smaller  surface  areas.  A  small  ball 
and  a  disc,  flat  on  one  side,  and  convex  on  the  other,  which 
can  l)e  screwed  to  tlie  end  of  the  terminal,  are  provided 
for  this  puri)0se.  The  spark  may  be  applied  to  the  metal 
band  at  the  lower  extremity  of  the  vulcanite  handle  or  to 
the  metal  terminal  in  contact  with  the  patient.  See  Plate 
II.  The  only  dis;idvantage  of  this  tyjx'  of  s]»ark-director 
occurs  when  the  sparks  are  applied  over  the  clothing  when 
if  the  handl«>  is  a  partial  con<luctor,  as  a  wooden  handle 
is,  short  sparks  pa.'is  from  the  operator  to  the  patient,  be- 


36  HIGH-POTENTIAL  CURRENTS 

tween  the  terminal  and  the  skin,  when  it  is  put  in  contact 
with  the  skin,  or  constantly  while  held  over  intervening 
clothing.  This  is  generally  obviated  by  the  long  vulca,nite 
handle.  Another  device  used  for  making  the  application 
of  spajrks  in  this  manner  is  the  crooked  chain  holder  which 
has  been  supplied  with  most  static  machines,  Fig.  7.  By 
placing  the  curved  end  upon  the  surface  to  be  treated 
so  that  the  metal  is  in  contact  with  more  or  less  surface, 
it  is  possible  to  vary  the  intensity  of  the  local  effects, 
without  changing  the  length  of  the  spark.  In  other  words 
when  a  larger  surface  of  metal  is  applied  to  the  skin,  the 
same  length  of  spark-gap  produces  relatively  less  intense 


O- 


m 


Fig.  7.     Chain  Holder  Used  as  Spark  Director. 

effects  upon  the  tissues.  By  means  of  these  various  de- 
vices, it  is  possible  to  administer  sparks  with  varying 
intensity,  and  in  the  hollows  or  clefts  or  within  the  cavities 
to  which  it  would  be  otherwise  impossible  to  apply  sparks. 
Another  advantage  in  applying  sparks  in  this  way  is  that 
the  moral  effect  upon  the  patient  who  sees  a  spark  escap- 
ing from  his  person  is  often  alarming,  whereas,  when  the 
spark  escapes  to  the  metal  part  of  the  spark-director, 
though  the  effect  is  the  same,  the  patient  has  not  the  same 
concern. 

The  therapeutic  indications  for  the  employment  of  static 
sparks  cover  a  very  wide  range  of  conditions;  for  they 
include  most  of  the  inflammatory  affections,  excepting 
those  associated  with  an  infectious  process.  They  are  par- 
ticularly efficacious  in  treating  inflammations  of  the  large 


73 


DISRUPTIVE  DISCHAKGES,  SPARKS  M 

and  small  joints,  aiul  for  relieving  the  muscular  tension 
and  local  infiltration  of  neuritis. 

The  idea  so  often  expresstnl  by  physicians  that  static 
sparks  aiv  too  painful,  ami  that  their  patients  will  not 
submit  to  them,  is  mainly  the  fault  of  the  oi^erator  and 
his  method  of  employing  them.  In  cases  of  brachial 
neuritis  the  infra  scapular,  triceps,  deltoid  and  pectoral 
muscles  are  to  varying  degrees  in  a  condition  of  muscular 
spafim,  occasioning  the  patient  discomfort,  and  pain  on 
moving  the  arm.  If  in  such  a  case  the  oj^erator  will  apply 
sparks  to  these  muscles  directing  him  to  move  the  arm 
or  the  part  contracted  following  the  application  of  a  few 
sparkss  the  patient  will  soon  become  enthusiastic  owing 
to  the  relief  which  they  afford.  There  is  no  modality  in 
which  the  matter  of  technique  is  of  so  much  importance 
as  in  the  emplojTnent  of  static  sparks.  The  knowledge 
of  the  relation  of  inflammatory  conditions  to  the  induc- 
tion of  muscular  s-pasm  must  always  be  considered  as  an 
indicatiim  for  the  application  of  sparks. 

In  brachial  neuritis  groups  of  muscles,  as  previously 
stated,  are  in  a  state  of  spasm.  The  application  of  sparks 
following  the  wave  current  for  the  purpose  of  relieving 
this  tensi(m,  judiciously  applied  first  to  one  muscle  and 
then  to  another  is  remarkabi}'  elective;  and  the  patient 
soon  appreciates  the  value  of  the  application;  f(>r  day 
after  day  the  pain  becomes  less,  and  th<*  limb  is  moved 
with  more  freedom;  and,  following  each  application  of 
well  directe<l  sparks  the  part  is  fre*-  from  pain  and  tension, 
and  a  fe<'ling  of  lightness  n'places  the  sense  of  weight 
and  the  painful  condition  of  the  part. 

In  cases  of  rlu  imuitoid  (irt)iri(is,  and  (►thor  con<lition8 
of  nniltiple   arthritis  or  arthritis  of  a   singb'  j(Mnt,   the 


38  HIGH-POTENTIAL  CURRENTS 

tension  of  the  muscles  in  the  vicinity  of  the  joints  and 
of  the  long  muscles  of  the  arm  which  pass  to  the  fingers, 
is  remarkably  relieved  from  the  discomfort  and  rigid  con- 
dition in  the  joints  involved  by  the  application  of  sparks, 
conveniently  applied  by  passing  the  sparking  ball  parallel 
to  the  tense  muscles.  This  coincidently  relieves  the  joint 
from  the  pressure  thus  exerted  upon  the  iuterarticular 
cartilages. 

In  the  case  of  a  sprained  ankle,  within  the  first  thirty- 
six  hours  after  the  accident  the  long  muscles  are  in  a 
state  of  marked  tension;  and  in  the  chronic  condition 
which  follows  the  improper  treatment  of  the  sprain  certain 
movements  of  the  joint  will  be  painful  due  to  pressure 
upon  the  infiltration  present  between  the  bones  particu- 
larly the  malleoli  and  the  astragalus,  which  will  not  be 
relieved  except  the  spark  be  also  judiciously  applied  along 
the  contracted  muscles.  Long  sparks  applied  by  quick 
movement  in  which  the  ball  is  passed  parallel  to  muscles 
in  a  state  of  tension  or  short  sparks  in  rapid  succession 
promptly  relieves  the  tension  and  adds  greatly  to  the 
comfort  of  the  patient.  The  same  is  true  of  muscular 
spasm  associated  with  neuritis ;  and  the  same  treatment  is 
indicated.  No  measure  is  so  effective  as  the  static  spark 
in  promptly  relieving  muscular  tension. 

Applications  of  sparks  to  the  joints  should  always  be 
directed  to  the  internal  tissues  in  the  spaces  between  bony 
prominences,  as  around  the  patella  in  inflammations  of 
the  knee  joint.  A  spark  applied  indirectly  over  the  bone 
gives  practically  no  relief  to  the  joint  inflammation; 
whereas,  a  spark  applied  to  the  soft  structures  over  the 
intervals  between  the  bony  prominences  lessens  the  infil- 
tration and  relieves  the  condition.    The  treatment  of  rheu- 


DI8KI  PTIVE  DISCHARGES,  SPARKS 


39 


matoid  arthritis  bv  the  employment  of  the  static  sparks 
painful  th()ujj:h  they  are,  calls  forth  expressions  of  grati- 
tude from  the  patient  when  they  are  judiciously  and  con- 
siderately applied. 

The  regulation  of  the  spark  length  in  making  these  ap- 
plications is  of  most  importance.  To  apply  large  sparks 
to  small  sensitive  joints  is  painful  and  inexcusable.  Sparks 
applied  to  the  tiugers  and  wrists  should  not  exceed  one- 
half  to  three-quarters  of  an  inch  in  length;  the  former  to 
the  lingers,  and  the  latter  to  the  wrist  joints.  These  are 
capable  of  producing  all  the  good  with  a  minimum  of 
discomfort  to  the  patient. 


I'lu.  8.     Author's  IVur-Shapcd   Jiall. 


///  fhr  trattment  of  chronic  inflammations  of  joints  and 
all  cases  of  neuritis,  there  is  little  danger  of  applying  too 
many  sjtarks,  except  that  they  fatigue  the  patient;  whereas 
in  acute  sciatica  and  other  types  of  neuritis,  the  applica- 
tion of  too  great  a  number  will  often  bring  on  a  relapse, 
when  a  case  had  been  satisfactorily  progressing.  This  has 
occasionally  occni-rt'd  in  the  writer's  expericnec,  through 
the  injudicious  use  of  sparks  by  assistants. 

For  administering  static  sparks  the  pear-shaped  ball, 
Fig.  8,  designed  by  the  author,  is  the  most  practical  type. 
It  was  designed  for  the  additional  purpose  of  admin- 
istering friction  sparks  to  convex  snrfa<es,  for  whicli 
purpose  the  so-called  massage  roller  served  awkwardly 
the  purpose. 


40  HIGH-POTENTIAL  CURRENTS 

Resonator  sparks.  See  Plate  IV.  Resonator  sparks, 
or  the  sparks  administered  from  a  static  resonator  with 
a  ball  electrode,  are  generally  indicated  in  conditions  in 
which  it  is  sought  to  bring  about  active  hyperemia;  but 
are  in  no  respect  equal  in  efficiency  to  indirect  sparks  in 
the  treatment  of  inflammatory  conditions.  Whereas  they 
were  previously  employed  by  the  writer,  they  have  been 
generally  abandoned  except  in  the  treatment  of  skin  affec- 
tions. 


CHAPTER  V 

THE    CONVECTIVE    DISCHARGES    OR    EFFLEUVE 

The  electrical  discharges  tbat.are  given  off  from  metal 
points  or  from  a  relatively  non-conducting  material,  as  a 
wooden  stick,  either  from  a  i)oint  or  convex  surface  with- 
out the  passage  of  a  spark  or  disruptive  discharge,  are 
known  as  convectiue  discharges,  or  the  effleuve  of  the 
French. 

These  discharges  are  of  a  warm  or  hot  burning  charac- 
ter in  proportion  to  the  amperage  of  the  current  that  is 
passing  or  the  proximity  to  which  the  electrode  is  held 
from  the  surface  of  the  body.  The  direct  coil  effleuve  is 
consequently  relatively  hot,  and  unless  held  at  consider- 
able distance  will  generally  produce,  in  a  very  short  time, 
distinctly  cauterant  effects. 

The  static  discharges  of  this  character  have  been 
designated  as  the  spray  or  brush  discharge.  The  former 
is  administered  from  a  metal  point,  and  the  latter  either 
from  a  metal  or  wooden  terminal  is  passed  through  or 
over  a  wooden  electrode.  The  latter  material,  offering  a 
distinct  resistance,  prevents  the  current  passing  in  a 
smooth  discharge  except  when  discharged  from  a  point, 
when,  other  things  being  equal,  it  is  much  the  same,  but 
less  irritating  than  the  discharge  from  a  metal  point. 

The  sprag  is  the  oldest  fonn  of  convective  discharge 
and  has  been  used  by  many  operators  in  the  past,  both 

41 


42 


HIGH-POTENTIAL  CURRENTS 


from  single  and  multiple  point  electrodes.  (See  Figs.  9 
and  10.)  Its  characteristics,  however,  for  the  relief  of 
inflammatory  conditions,  in  which  affections  these  dis- 


FiG.  9.    Single  Point  Electrode. 

charges  are  usually  employed,  is  not  as  effective  as  those 
of  the  brush-discharge,  which  is  therefore  the  elected 
means  of  employing  the  convective  methods  of  treatment 
from  a  static  machine.  This  method  may  also  be  admin- 
istered from  a  low-frequency  coil  resonator. 


Fig.  10.    Multiple-point  Wire  Brush  Electrode  for  Administering  Spray. 

The  brush-discharge  (a  therapeutic  expression  in  tech- 
nical variance  with  physics),  administered  preferably 
from  a  green,  unseasoned  wooden  electrode  about  3-4 
inches  in  diameter  (see  Fig.  11),  serves  a  valuable  pur- 
pose in  therapeutics.  The  discharge  has  a  distinctly  dis- 
ruptive characteristic,  as  if  multitudes  of  little  sparks 
were  passing  in  rapid  succession,  producing  a  feeling 
when  projected  against  the  surface  as  if  sharp  particles 
of  sand  were  thrown  against  the  skin.     This  characteris- 


CONVECTIVE  DISCHARGES  OR  EFFLEUVE    43 

tic  led  Dr.  liuiiipliries  to  designate  it  *  as  a  disrupto-con- 
vective  discharge,  wliicli  practically  explains  the  charac- 
ter of  its  action.  To  this  disruptive  feature  or  impulsive 
character  of  the  discharge   is   largely   due   its  greater 


KiG.    11.      Autlior's   Set   of   Brusii-Diseharge   Plli'ctro.lt-. 

2  and  3,  Wooden  Terminals;  8,  Insulati-il  Metal  Terminals,  and  Dr.  Xealy'a 

Glass  Glycerine  Filled   Brusii-Discharge  Klectrode. 

degree  of  beneficial  action  in  the  treatment  of  su})erficial 
inflammatory  conditions,  to  which  it  is  so  well  ada})ted. 

This  modality  is  administered  uniformly  with  the  ])a- 
tient  seated  upon  the  insulated  platform.  The  discharg- 
ing rods  should  be  widely  separated  and  the  patient  hold 
the  shepherd's  crook  in  the  hands  or  having  the  feet  bare 
upon  a  metal  plate,  connected  with  the  negative  side  of 
the  machine,  and  the  ])ositive  side  should  be  grounded.  It 
is  demonstrated,  and  a  wcll-recogiiizcd  fact  that  when  the 
patient  is  connected  to  the  positive  side,  the  effect  is  dis- 
tinctly irritating,  as  well  as  aggravating  to  inflammatory 
conditions.  The  object  in  having  the  i)atient  brought 
thus  in  direct  connection  with  the  machine  is  that  the  cur- 
rent may  not  be  diffused  too  much  over  the  platform  and 
other  part  of  the  insulated  portion  of  the  apparatus  be- 

*  See  Dr.  Humphries'  Chart  of  Static  Modalities,  published  by  mc  Ilospilal 
Supply  Co.  New  York. 


44  HIGH-POTENTIAL  CURRENTS 

fore  passing  to  the  patient,  thereby  permitting  a  much 
more  energetic  administration  with  a  lower  rate  of  speed, 
which  latter  may  be  varied  to  the  demands  of  the  case. 
If  the  wooden  electrode  does  not  permit  a  discharge  of 
two  or  three  inches  between  the  surface  of  the  patient 
and  the  end  of  the  electrode,  which  is  desirable  for  most 
administrations,  the  speed  of  the  machine  may  be  accel- 
erated or  the  surface  of  the  electrode  may  be  dampened 
from  time  to  time  with  a  wet  cloth  held  for  the  purpose  in 
the  hands  of  the  operator.  By  the  emplojTnent  of  mois- 
ture in  this  manner  it  is  possible  to  apply  these  dis- 
charges from  an  old  seasoned  stick,  but  the  discharge  is 
never  as  smooth  and  satisfactory  as  when  administered 
from  an  unseasoned  stick.  The  wood  of  which  these 
electrodes  are  made  should  be  of  some  uniform  texture 
not  having  a  coarse  grain,  such  as  cottonwood,  whitewood, 
basswood,  or  what  is  still  better,  the  white  portion  of  the 
sugar  maple.  The  maple  sticks  do  not  dry  out  or  season 
so  rapidly  as  the  whitewood  or  other  soft  woods. 

When  administering  the  current  the  operator  should 
hold  the  sliding  metal  collar  provided  with  the  screw  eye 
for  attachment  of  the  hook  of  the  grounding  chain  upon 
the  surface  of  the  electrode,  so  that  it  reaches  just  beyond 
the  finger,  elsewise  the  discharges  will  produce  a  disagree- 
able, burning  sensation  to  the  hand.  In  lieu  of  a  prop- 
erly made  collar,  a  few  windings  of  a  strip  of  soft  metal 
upon  the  end  of  the  stick,  with  the  grounding  chain  pass- 
ing to  the  metal,  will  answer  the  same  purpose.  The 
operating  chain  may  or  may  not  be  connected  to  the  earth, 
the  current  passing  through  the  operator.     This  will  de- 


CONVECTIVE  DISCHARGES  OR  EFFLEUVE    45 

pend  upon  the  intensity  of  the  discharge  tliat  is  re(|uired. 
If  it  is  desirable  to  get  a  pronounced  effect  the  current 
should  be  grounded,  otherwise,  as  in  making  applications 
about  the  eye,  or  within  the  ear  or  fauces,  the  machine 
may  be  run  slowly  and  the  current  grounded  through  the 
person  of  the  operator  to  the  floor  of  the  room.  In  this 
event  the  operator  should  avoid  contact  with  metal  con- 
ductors or  suffer  unpleasant  shocks. 

A  condition  which  may  arise  when  the  static  machine 
is  running  rapidly  and  prove  unpleasant  to  the  patient, 
will  result  from  the  passage  of  sparks  arcing  across  on 
the  interior  of  the  machine  which  will  cause  very  dis- 
agreeable contractions  at  the  wrist.  Under  these  condi- 
tions, the  machine  should  be  run  at  a  lower  rate  of  si)eed, 
and,  if  necessary  to  get  the  desired  effect,  the  outer  sur- 
face of  the  electrode  may  be  made  more  moist.  An  un- 
pleasant circumstance  which  may  occur  with  the  unini- 
tiated, will  arise  from  the  passage  of  a  spark  between  the 
balls  of  the  discharging  rods,  which  have  not  been  widely 
sei>arated.  Another  point  to  be  observed  is  that  when  ad- 
ministering the  brush-discharge  the  patieu*^  should  sit  di- 
rectly opposite  the  pole  to  wliich  he  is  connected, — the 
negative  side; — otherwise  the  current  will  arc  across, 
producing  a  burning  sensation  ii])<)ii  the  surface  of  the 
patient  nearest  the  positive  prime  conductor. 

During  thr  adminisf ration,  the  electrode  in  the  hands 
of  the  oi)erator  should  never  be  held  in  a  fixed  position, 
but  should  be  moved  about  constantly  over  the  surface 
to  which  he  is  making  the  a]iplication.  This  is  done  for 
two  reasons: — (1)  because  the  interrupted  character  of 


46  HIGH-POTENTIAL  CURRENTS 

the  discharge  administered  in  this  way  produces  impulses 
of  contraction  in  the  underlying  tissues,  and  (2)  because 
the  application  from  an  electrode  held  in  a  fixed  position 
is  too  severe  to  be  borne  by  the  patient.  Under  most 
conditions  a  wooden  electrode  after  a  time  becomes  carbon- 
ized through  its  length  or  certainly  for  a  portion  of  the 
length,  at  the  end  nearest  the  patient.  The  discharge  will 
then  become  similar  to  the  spray  given  off  from  a  metal 
point  electrode.  Under  these  conditions,  the  electrode 
should  be  thoroughly  moistened  over  the  extremity,  when 
the  discharge  will  again  assume  the  disrupto-convective 
character  producing  the  sense  of  hot  sand  thrown  against 
the  surface.  The  brush-discharge  is  one  of  the  most  val- 
uable high-potential  modalities,  and  the  technique  of  ap- 
plication is  not  difficult  if  the  above  suggestions  are  fol- 
lowed literally. 

The  effleuve  from  a  coil  may  be  administered  either 
from  the  coil  direct  or  from  a  resonator.  In  the  latter 
case  the  amperage  is  considerably  diminished  and  the  hot 
burning  sensation  much  lessened.  It  may  be  adminis- 
tered from  a  metal  point  or  carbon  electrode,  as  the  dis- 
charges of  this  character  will  not  pass  through  the 
wooden  electrode  with  sufficient  efficiency  to  be  of  value. 
These  discharges  will  vary  in  length  and  potency  with 
the  potential  of  the  apparatus  from  which  they  are  de- 
rived, and  should  be  held  at  a  distance  at  which  the  effect 
produced  may  be  borne  by  the  patient,  when  moved  rap- 
idly over  the  surface,  the  effect  of  which,  as  stated,  is  to 
produce  a  superficial  hypersemia.  The  effectiveness  of 
these  discharges  in  therapeutics,  while  valuable  in  pro- 


CONVECTIVE  DISCHAKGES  OR  EFFLEUVE    47 

duciiij?  a  condition  of  bypeni'niia,  is  rather  too  severe 
for  application  to  most  inHanunatory  conditions,  except 
those  conditions  where  a  local  cauterant  action  is  desir- 
able, as  in  the  destruction  of  a  local  septic  process  which 
is  superficial  in  character.  If  the  coil  current  is  used 
for  the  relief  of  inHanunatory  conditions,  it  is  much  more 
desirable  to  use  tlie  sharj)  resonator  spark,  which  has  been 
described  in  the  preceding  chajjter;  or  from  a  modern 
electrode  having  a  metal  collar  connected  with  a  low- 
frequency  resonator  discharge,  a  brush-discharge  may 
be  administered  if  the  surface  of  an  electrode  of  wood  is 
kept  thoroughly  moistened. 

The  phiis'iological  action  of  the  convective  discharges 
is  of  considerable  importance. 

Bubcfacience — the  production  of  a  distinct  redness 
— occurs  when  the  application  is  made  to  one  surface 
for  a  considerable  time,  occasioned  by  the  irritation  of 
the  superficial  capillaries.  The  effect  of  the  discharges 
is  very  distinctively  antiseptic  on  account  of  the  heat 
produced,  and  also  owing  to  the  action  of  ozone  and 
nitrous  acid  and  the  intense  vibration  effects  of  the 
discharges  of  light  frequencies  upon  organic  germ  life. 

The  action  upon  the  tissues  of  the  interrujited  con- 
vective discharges  over  inflammatory  conditions  is  to 
relieve  local  stasis,  softening  the  underlying  tissues,  by 
rciin)ving  the  induration  that  is  pre.«v<'nt,  tlien-by 
restoring  normal  circulation  to  the  parts  and  institut- 
ing an  active  local  metabolism.  This  effect  is  also 
followed  naturally  by  a  resumption  of  tone  in  the  arte- 
rioles beneath  the  skin,  which  is  shown  from  the  fact 


48  HIGH-POTENTIAL  CURRENTS 

that  there  is  no  disposition  to  relapse,  which  would 
otherwise  occur.  When  these  discharges  are  applied 
over  oozing  ulcerated  surfaces,  the  surface  becomes 
covered  witli  a  coating  or  film,  shiny  in  appearance — as 
if  the  surface  had  been  brushed  over  with  collodion. 
This  is  due  to  evaporation  and  the  contraction  of  the 
superficial  cells  and  forms  a  protection  to  the  surface 
which  will  persist  for  a  considerable  time.  When  applied 
too  intensely  and  for  too  long  a  time  to  a  small  surface, 
the  discharges  will  produce  a  blister  or  an  eschar,  burn- 
ing the  tissue.  These  effects  are  produced  most 
promptly  by  the  larger  ampere  discharges  from  a  coil 
eflfleuve.  The  only  purpose  that  this  effect  will  serve  in 
therapeutics  is  the  destruction  of  small  areas,  as  warts, 
moles,  or  angiomata,  and  in  cases  in  which  there  is 
a  suspicion  of  local  sepsis  or  the  bite  of  a  snake,  or 
where  an  abraded  surface  has  been  exposed  to  septic 
infection. 

Rubefacience.  The  general  application  of  the  dis- 
charges to  the  surface  of  the  body,  producing  a  dilata- 
tion of  the  superficial  capillaries,  will  greatly  relieve 
arterial  tension  and  lessen  the  labor  of  the  heart  under 
various  conditions,  as  those  present  in  arteriosclerosis. 
It  also  acts  as  a  local  counter  irritant,  relieving  deep 
congestion  under  the  general  principles  of  the  use  of 
counter  irritants.  The  indications  for  its  use  are  in 
arterio-sclerosis  as  suggested,  and  over  inflammatory 
conditions  where,  in  addition  to  the  effects,  to  be  shown 
later,  upon  the  deep  congestion,  the  additional  effects  of 
counter  irritation  are  produced. 


CONVECTIVE  DISCHARGES  OR  EFFLEUVE    49 

llie  antiseptic  action  due  to  the  cauteraiit  oxidizing  and 
chemical  effects  of  nitrous  acid  and  the  intense  vibrations 
of  the  violet  discharges,  though  very  superficial  in  their 
action,  are  sufficiently  energetic  to  destroy  certain  types 
of  infection,  notably  in  superficial  cases  of  lupus  vulgaris 
and  lupus  erythematosus.  The  author  has  relieved  a  case 
of  lupus  vulgaris  in  six  weeks  and  with  no  other  ai)plica- 
tion  than  that  of  the  brush-discharge,  which  had  been 
under  treatment  by  various  local  applications  for  a  year 
and  a  half.  It  must  not  be  presumed  that  these  convective 
discharges  transmit  the  products  of  decomposition  pro- 
duced in  a  spark  discharge  or  effleuve  beneath  the  surface, 
or  that  it  is  possible  to  carry  an  ionizing  influence  beneath 
the  integument.  It  must  be  also  understood  that  the 
discharges  are  from  the  patient  and  not  towards  the 
patient  as  the  appearance  might  lead  the  casual  ob- 
server to  suspect.  Also,  as  stated  above,  these  dis- 
charges are  effective  for  the  relief  of  local  infection  in 
the  superficial  layer  of  the  skin  when  applied  energeti- 
cally enough  to  produce  an  almost  cauterant  effect  upon 
the  tissues,  as  over  an  infected,  abraded  surface,  as  sug- 
gested above.  Another  effect,  which  might  be  considered 
in  a  sense  antiseptic,  in  that  it  admits  the  leucocytes  and 
phagocytes  to  free  access  to  an  infection  where  an  abscess 
will  form,  is  explained  in  the  following  paragraph. 

The  effect  upon  local  stasis  of  the  convective  dis- 
charges, when  aiii)lied  interru])tedly  passing  the  dis- 
charge to  and  fro,  l)a('k  and  forth  over  the  different 
parts  of  the  surface  where  swelling  and  induration  are 
present,  is  to  generally  soften  the  tissues.     This  is  due 


50  HIGH-POTENTIAL  CURRENTS 

to  the  action  of  the  discharges  producing  recurrent  con- 
tractions of  the  tissues,  thereby  inducing  an  onward 
movement  of  the  blood  current  through  the  vessels. 
Over  superficial  oedema  as  present  in  some  cases  of 
eczema  and  the  swelling  associated  with  bruises  and 
sprains  and  where  ecchymosis  is  present,  the  effect  of 
these  applications,  systematically  applied,  is  remarkable 
in  its  results.  In  conditions  where  local  infection  has 
set  up  an  abscess  process,  as  in  felons  (whitlows)  and 
boils,  the  effect  of  the  early  application  by  overcoming 
local  stasis  and  softening  the  tissues  permits  the  blood 
to  flow  in  freely  through  the  area,  enabling  the  leuco- 
cytes and  phagocytes  to  destroy  the  infecting  germs 
and  restore  the  conditions  to  normal,  where  otherwise 
would  supervene  a  painful  abscess  process.  Nothing 
could  be  more  gratifying  than  the  results  in  these  cases. 
The  action  upon  local  stasis  is  not  only  to  relieve  the 
conditions,  but  also  to  restore  tone  to  the  arterioles  fol- 
lowing the  application,  thereby  preventing  prompt  re- 
lapse of  the  condition  and  furthering  prompt  and 
complete  recovery.  The  application  also  undoubtedly 
stimulates  end-organ  metabolism  and  the  elimination  of 
effete  materials,  tending  thereby  to  restore  normal  con- 
ditions in  the  shortest  possible  time. 

The  indications,  then,  for  these  applications  are  for 
the  relief  of  all  swollen  and  indurated  conditions  in 
which  pus  is  not  present  in  sufficient  quantity  to  induce 
general  infection  by  its  escape  into  the  general  circula- 
tion, nature  having  provided  induration  for  the  walling 
off  of  a  pus  cavity.    In  cases,  however,  in  which  the  in- 


CONVECTIVE  DISCHARGES  OR  EFFLEUVE    51 

fection  is  but  slight  the  effect  is,  as  suggested,  to  assist 
the  leucocytes  and  phagocytes  to  relieve  the  system  of 
the  infection.  It  will  require  some  careful  discrimina- 
tion on  the  part  of  the  operator  to  determine  the  stage 
of  the  condition  he  has  to  deal  with.  As  a  rule,  within 
the  first  two  days  of  a  felon  or  boil  the  relief  of  local 
stasis  portends  no  harm  to  the  patient  from  dissemina- 
tion of  the  infection.  In  cases  of  tonsilitis,  the  result  is 
most  happy,  if  applied  at  the  early  stage,  during  the 
first  day  of  the  lesion,  directly  over  the  indurated  spot, 
externally.  The  application  should  be  continued  until 
no  induration  remains,  and  repeated  on  the  following  day. 

The  range  of  application  of  these  modalities  also  in- 
cludes the  superficial  skin  diseases,  lu})us  vulgaris, 
lupus  erythematosus,  eczema,  psoriasis,  lieri)es,  sycosis, 
favus,  and  numerous  non-infected  conditions  associated 
with  interference  in  the  normal  metabolism  of  the  skin. 

In  acne,  however,  the  application  of  the  brush-dis- 
charge is  not  indicated,  as  the  condition  is  not  a  local 
one,  and  it  seems  to  cause  a  thickening  of  the  skin  with- 
out relieving  the  process  when  ap])lied  for  a  long  time. 
In  furunculosis  it  is  also  dangerous,  as  it  is  likely  to 
drive  the  infection  elsewhere,  as  it  will  if  the  applica- 
tion is  made  energetically  to  the  surface.  For  these 
conditions,  there  are  other  means  at  hand, — light  and 
the  X-ray,  which  are  as  a  rule  effective. 

To  ulcerated  surfaces  the  api)lication  of  these  modali- 
ties is  one  of  the  most  valuable  in  therapeutics.  Ap- 
plied over  the  indurated  margin,  where  it  has  a  positive 
effect  in  removing  stasis,  it  proves  to  be  of  the  greatest 


52 


HIGH-POTENTIAL  CURRENTS 


value  for  the  relief  of  those  conditions.  The  circula- 
tion is  restored  throughout  the  zone  of  induration  which 
surrounds  the  ulcer,  when  a  reparative  process  is  im- 
mediately instituted. 

For  application  ivithin  the  cavities  of  the  body  the 
brush-discharge  may  be  administered  in  connection 
with  the  glass  sleeves  that  are  shown  in  Fig.  12.     These 


Fig.  12.     Glass  Sleeves  for  Use  with  Brush-Discharge. 

sleeves  are  slipped  over  the  small  prolongation  tip  (Fig. 
13)  which  is  placed  in  the  end  of  the  ordinary  wooden 
stick  electrode,  and  are  designed  for  application  to  the 


Fig.  13.    Prolongation  Tip  for  Use  with  Brush-Discharge. 

cervix,  in  the  fauces,  and  in  the  clefts  as  about  the  anus, 
where  it  is  impossible  to  cause  the  discharge  to  pass 
directly  from  an  electrode  by  other  means.  The  sleeve 
may  be  moved  to  or  fro  on  the  end  of  the  wooden  stick, 
permitting  a  discharge  of  varying  lengths  to  pass.  The 
sleeve  with  tapered  end  is  made  for  application  to 
the  ear,  either  for  treatment  of  furuncles  or  for  applica- 
tion to  the  drum  or  in  otitis  media,  or  the  discharge  may 


CONVECTIVE  DISCHARGES  OK  EFFLEUVE    55 


be  thrown  into  the  middle  ear  for  treatment  of  the  affec- 
tions present  in  sui)purative  otitis  media.  In  these 
conditions,  success  must  depend  upon  the  extent  of  the 
lesions  present  and  upon  the  proximity  to  which  the  dis- 
charges may  be  brought  to  them  and  the  dexterity  of 
the  operator. 


CHAPTER  VI 

HIGH-POTENTIAL    CURRENTS    WITH   VACUUM   TUBES 

Vacuum  tubes  employed  in  connection  with  high-poten- 
tial currents  were  first  constructed  of  the  Geissler  type, 
having  a  wire  passed  from  without  to  the  interior  of  the 
tube.  A  later  type  which  serves  the  same  purpose  is  the 
plain  vacuum  tube  without  any  metallic  connection  with 
the  interior.  Both  types  of  tubes  are  made  in  various 
forms  suited  to  the  treatment  of  special  conditions,  and 
also  having  various  degrees  of  vacuum.  They  may  be 
employed  with  any  high-potential  apparatus  provided 
with  an  interrupter,  and  do  not  necessarily  require  that 
the  discharges  be  of  high  frequency.  The  term  so  often 
employed  of  '^  high-frequency  vacuum  tubes  "  is  there- 
fore technically  a  misnomer.  While  it  is  necessary  that 
there  be  interruptions  somewhere  in  the  circuit  of  a 
current  of  high  potential  to  produce  these  effects,  high 
frequency  is  not  essential.  The  term  which  should  be 
employed  in  therapeutics  with  reference  to  these  tubes 
should  therefore  be  high-potential  vacuum  tithes  if  re- 
ferred to  therapeutics,  or  vacuum  tubes  for  use  in  con- 
nection with  high-potential  currents.  The  tendency  for 
terms  to  creep  into  medical  literature  which  are  unau- 
thorized and  unscientific,  and  which  call  for  corrections 
and  establishment  later  of  a  different  nomenclature,  has 
led  to  much  confusion  in  the  past. 

54 


VACUUM  TUBES  55 

The  phenomena  of  the  liigh-i)oteutial  discharges  having 
various  degrees  of  interruption  in  connection  with 
vacuum  tubes  are  unique.  That  the  effect  upon  a  hollow 
tube  having  an  attenuation  of  gases  in  the  interior  is  as- 
sociated with  peculiar  electrical  phenomena,  whereas  one 
containing  the  ordinary  atmosi^heric  air  is  void,  has  led  to 
a  study  of  electrons  as  excited  under  conditions  which  are 
peculiar  to  the  different  degrees  of  vacua  of  the  various 
tubes.  That  the  vacua  of  these  tubes  may  also  be  so 
highly  attenuated  that  no  phenomena  are  produced  leads 
to  another  conclusion — that  these  effects  are  not  due  to 
the  action  of  the  current  upon  the  ether,  but  upon  the 
gases  in  the  ether  under  definite  conditions  of  attenua- 
tion, showing  that  it  is  necessary  to  the  phenomena  that 
there  be  present  within  the  tubes  gases  of  proper  den- 
sities. 

When  a  tube  of  the  requisite  attenuation  is  brought  in 
proximity  to  a  high-potential  source  of  electrical  energy, 
even  when  a  short  air-gap  intervenes,  it  is  illuminated  by 
the  phenomena  of  the  cathode  rays  giving  evidence  of  the 
presence  of  negative  electrons  within  the  tube,  demon- 
strating an  affinity  of  cathodal  high-potential  electricity 
for  the  attenuated  gases  within  these  tubes. 

The  fact  that  the  negative  electrons  of  high-potential 
currents  are  attracted  to  certain  degrees  of  atmosjiheric 
attenuation  may  ex])lain  some  of  the  ])henomena  in  the 
rarefied  jiortions  of  the  atmos])here. 

The  chnracteristics  of  these  electrons  are  described  by 
Sir  Oliver  Lodge  in  speaking  of  the  cathode  rays  *  as 

*  Archives  of  the  RoeDtgen  Rny  for  April,  pages  185,  186. 


56  HIGH-POTENTIAL  CURRENTS 

follows:  "  It  is  from  these  rays  (the  cathode  rays)  that 
most  of  the  others  are  derived.  It  is  owing  to  a  study  of 
their  nature  that  so  much  advance,  almost  of  a  revolution- 
ary character,  has  been  made  recently  in  the  science  of 
electricity — advance  which  must  have  a  perfect  bearing. 
The  cathode  rays  are  flying  electrical  particles  called  elec- 
trons— actually  particles — I  cannot  say  particles  of  mat- 
ter because  they  appear  to  he  particles  of  ivhich  matter  is 
composed,  they  are  particles  of  electricity.  We  now  know 
that  electricity  is  really  an  atomic  thing  in  the  sense  of 
having  actual  particles,  and  these  particles  are  called  elec- 
trons. They  fly  along  in  the  cathode  rays.  Their  motion 
constitutes  all  electrical  currents.  They  go  round  in 
magnets  and  are  in  fact  the  substitute,  the  substratum  of 
the  whole  electric  science.  When  they  are  intercepted 
they  give  rise  to  radiation;  when  they  revolve  they  also 
give  rise  to  radiation.  It  is  their  acceleration  which  ex- 
cites all  radiation,  and  when  they  are  suddenly  stopped, 
as  when  impinging  on  a  solid  target,  they  give  rise  to  X- 
rays.  Wherever  you  have  these  flying  electrons,  these 
cathode  rays,  sometimes  called  Beta  rays,  where  they  con- 
stitute one  variety  of  radiation  from  radium — wherever 
you  have  these  rays  striking  and  stopped  suddenly — the 
X-rays  take  their  origin."  The  positive  ions  are 
described  by  the  same  writer  as  ''  slow-moving  ions  of 
large  size, "  or  ' '  heavy  things  which  we  are  beginning  to 
consider  as  quite  a  massive  sort  of  thing, — they  get  to  the 
cathode  and  in  that  way  complete  the  circuit. ' '  It  seems, 
therefore,  that  the  important  element  in  the  etfects  of 
these  vacuum  tubes   is  the  negative  ion  or  cathode  elec- 


VACUUM  TUBES  57 

tron,  and  that  the  positive  ions,  while  essentials  to  the 
presence  of  tlie  inductive  and  electrical  phenomena,  are 
far  less  significant  than  the  rapidly  moving  negative 
electrons. 

There  has  been  much  argument  and  controversy  as  to 
whether  electrons  pass  through  the  glass  of  the  vacuum 
tube.  Sir  Oliver  Lodge  in  the  same  paper  afTirms  that  the 
''  negative  electrons  do  pass  through  the  glass."  He  says 
that,  "  these  electrons  in  the  cathode  rays  themselves 
may  be  emitted  through  the  tube,  too,  and  as  a  matter  of 
fact,  in  addition  to  the  X-rays,  a  certain  number  of  Beta 
rays  or  cathode  rays  are  emitted."  "  It  is  owing  to  the 
escape  of  these  electrons  that  the  vacuum  has  a  tendency 
to  go  up  gradually  as  the  tube  is  used,  and  the  tube  thus 
has  a  tendency  to  become  practically  useless."  Again  he 
says  that,  ''  matter  seems  really  to  escape  through  the 
glass  in  the  shape  of  atoms  of  electricity,  for  it  cannot  get 
through  except  in  the  forms  of  electrons.  The  constit- 
uents of  the  matter  escape,  and  thus  the  matter  itself 
escapes.  If  you  hold  an  electroscope  near  the  bulb, 
you  will  get  the  effects  showing  that  these  electrons  are 
escaping." 

He  gives  another  explanation  of  the  phenomena  as  fol- 
lows: *'  It  appears  that  some  of  the  electrons  pass 
through  the  glass,  for  if  a  proof-plane  be  held  anywhere 
in  its  neighborhood  negative  electricity  can  be  collected, 
provided  the  proof-plane  is  removed  quickly  enough,  or 
the  tube  simultaneously  stopped,  so  that  its  ionizing 
power  shall  not  discharge  the  proof-plane." 

It  may  be  easily  demonstrated  that  the  phenomena  pro- 


58  HIGH-POTENTIAL  CURRENTS 

duced  either  within  a  vacuum  tube  having  no  leading-in 
wire  01  a  Geissler  tube,  are  exactly  the  same  when  con- 
nected with  a  high-potential  source  of  energy,  indicating 
that  the  discharges  which  pass  to  the  collar  of  the  tube 
holder  connecting  the  vacuum  tube  to  the  source  of  energy 
must  pass  through  the  glass  to  the  interior  of  the  tube, 
the  same  as  when  a  metallic  connection  enters  at  the  cor- 
responding end  of  a  Geissler  tube.  For  example:  if  a 
vacuum  tube,  having  no  leading-in  wire,  be  connected  by 
the  usual  method  with  a  connecting  wire  to  the  negative 
side  of  a  Holtz  machine,  or  a  Ruhmkorff  coil,  the  dis- 
charge— the  cathode  stream  that  passes  to  the  opposite 
end  of  the  tube — will  produce  a  green  spot  of  fluorescence, 
if  the  vacuum  of  the  tube  is  of  sufficiently  high  vacuum, 
at  the  end  where  the  cathode  rays  impinge,  indicating  the 
presence  of  the  X-ray.  The  same  effect  will  be  produced 
in  the  end  of  a  tube  of  the  same  vacuum  having  a  leading- 
in  wire  connected,  also,  to  the  negative  pole.  If  either 
tube  is  placed  against  some  substantial  object,  the  green 
fluorescence  is  immediately  transferred  to  the  side  of  the 
vacuum  tube  opposite  the  place  of  contact.  Another  ex- 
periment may  be  made  by  connecting  the  positive  pole  of  a 
Holtz  machine  or  a  Ruhmkorff  coil  with  the  two  kinds  of 
vacuum  tubes.  The  green  fluorescence  appears  at  the 
other  extremity  of  the  tube  beneath  and  around  the  metal- 
lic holder  of  the  vacuum  tube,  or  at  the  place  where  the 
wire  enters  the  Geissler  tube.  It  would  seem,  therefore, 
that  these  two  experiments  produce  precisely  the  same 
phenomena,  whether  the  current  is  conducted  to  the  in- 
terior of  the  tube  by  a  metallic  connection  or  not,  indicat- 


VACUUM  TUBES  50 

ing  that  the  electrons  are  admitted  through  the  glass  of 
the  tube.  These  demonstrations  and  the  experiments  of 
Sir  Oliver  Lodge  seem  to  demonstrate  that  the  negative 
electrons  do  pass  through  the  glass  of  the  tube,  not  ex- 
ceptionally but  invariably. 

The  various  color  effects  that  are  produced  within  the 
vacuum  tubes  when  the  negative  electrons  are  i)assiug, 
depend  upon  the  degree  of  the  vacuum,  except  that  the 
volume  or  richness  of  the  color  will  be  greatest  from  the 
sources  of  large  amperage.  The  color  produced,  there- 
fore, will  be  the  same  in  any  tube,  from  whatever  source, 
regardless  of  quantity  or  the  range  of  potential  that  will 
induce  them.  It  will  depend  upon  the  vacuum  of  the  tube, 
which  indicates  that  various  rates  of  ether  vibration  are 
induced  by  the  passage  of  the  cathode  rays  through  media 
of  varying  resistance,  up  to  the  point  where  the  vacuum 
becomes  so  high  that  these  rays  cease  to  pass,  when  no 
effect  whatever  seems  to  be  produced.  At  this  point  it 
is  probable  that  the  electrons  cease  to  pass. 

2  he  effects  of  frequency  upon  the  phenomena  are  evi- 
denced by  the  observer  in  recurrent  waves  of  color,  which 
pass  synchronously  with  the  rate  of  the  interrujition. 
These  waves  of  discharge  are  capable  of  exciting  vacuum 
tubes,  which  are  made  to  revolve  or  oscillate  back  and 
forth,  showing  groujis  of  discharge  in  lines  the  size  of 
the  hollow  of  a  revolving  or  oscillating  tube,  varying 
in  number  with  the  rate  of  the  condenser  discharges 
at  which  these  interruptions  occur.  To  demonstrate  this 
effect  take  in  the  hand  a  narrow  vacuum  tube  connected 
with  a  high-potential  source,  having  means  of  varying 


60  HIGH-POTENTIAL  CURRENTS 

the  rate  of  condenser  discharges,  and  cause  it  to  oscil- 
late back  and  forth,  and  note  the  effect.  G-roupings  of 
one,  two,  three,  four,  or  five,  or  more  of  these  lines  of  color 
may  be  made  to  appear  by  varying  the  frequency  and 
rates  of  oscillation. 

The  waves  of  cathode  rays  passing  with  the  negative 
electrons  will  flow,  if  the  tube  is  connected  to  a  source  of 
suflicient  energy,  in  recurrent  clusters  or  groups  of  oscil- 
lations passing  through  the  dielectric  to  the  object.  These 
waves  are  synchronous  with  the  interruption  at  the  spark- 
gap  of  a  static  machine  or  resonator,  or  a  mechanical  in- 
terrupter of  a  RuhmkorfP  coil.  For  making  this  experi- 
ment a  very  small  vacuum  tube  may  be  attached  to  the 
stem  of  a  metronome,  which  may  be  regulated  to  oscillate 
at  a  given  rate. 

The  chemical  effects  of  these  vacuum-tube  discharges 
are  the  production  of  various  combinations  characteristic 
of  electrical  discharges  in  the  atmosphere — derived  from 
the  expenditure  of  energy  upon  the  air,  and  a  change  in 
the  conditions  of  electrons  now  known  to  be  substantial 
things — producing  NO3,  O3,  H^O — and  other  products  of 
less  significance.  The  color  of  these  discharges  as  they 
pass  through  the  air  is  usually  violet,  but  varies  some- 
what with  the  intensity  of  the  discharges  to  almost  white. 
Various  other  physical  effects  are  produced  which  depend 
upon  the  sources.  When  connected  directly  to  the  static 
machine,  discharges  through  short  air-spaces  produce  a 
decidedly  irritating  and  stinging  sensation  as  they  escape 
from  the  surface.  The  discharge  is  in  bunches  or  multiple 
oscillations,  in  number  relative  to  the  length  of  the  air- 


VACUUM  TUBES  61 

gap  between  the  tube  and  the  i)atient,  tlie  frequency  of  tlie 
spark-gap  discharge,  and  the  volume  of  current  passing. 
When  discharged  from  a  resonator,  however,  the  poten- 
tial of  delivery,  the  spark  length  that  can  be  administered, 
will  be  slightly  longer  than  the  spark-gap  between  the  con- 
densers of  the  resonator  and  be  accomi)anied  by  a  multi- 
tude of  less  intense  oscillations  and  freciuencies.  These 
discharges  will  vary  with  the  type  of  resonator  or  sole- 
noid and  current  source  employed. 

The  convective  discharges  from  the  vacuum  tubes,  when 
derived  by  direct  connection  with  a  Ruhmkorff  coil,  are 
very  numerous  and  produce  a  severe  burning  sensa- 
tion, unbearable  when  held  at  a  short  distance  from  the 
skin. 

The  color  of  the  convective  discharges  varies  with  the 
intensity,  i.  e.,  the  color  of  the  discharge  between  the  tube 
and  the  body. 

By  connection  with  resonaters  and  solenoids  the  inten- 
sity of  these  discharges  may  be  greatly  varied  and  the 
number  of  oscillations  greatly  multiplied,  giving  these 
currents,  as  well  as  those  of  the  static  machine,  the  right 
to  be  termed  high-frequency  discharges,  i.  e.,  from  the 
standpoint  of  the  great  number  of  oscillations  emanating 
from  the  apparatus. 

The  physiological  effects  of  these  vacuum-tube  dis- 
charges are  varied,  dej^ending  u})on  the  source  of  elec- 
trical energy  and  the  character  of  the  resonator  or  sole- 
noid, which  intervenes  between  the  exciting  apparatus 
and  the  surface  to  which  the  discharges  are  ap]ilied. 

(1)   The  effects  are  of  a  stimulating  character,  produc- 


62  HIGH-POTENTIAL  CURRENTS 

ing  a  local  irritating  action  which  stimulates  the  super- 
ficial tissue  when  applied,  because  of  the  immediate 
irritating  effect  of  the  discharges,  and  are  distinctly  rube- 
facient. Locally  there  are  also  the  effects  of  the  chemical 
action  of  the  discharges  which  are  produced  by  the  pas- 
sage through  the  air  or  dielectric.  These  stimulating 
effects  to  the  periphery,  especially  when  applied  to  motor 
points,  produce  reflex  muscular  contraction,  as  well  as 
other  reflex  effects,  to  which  undoubtedly  the  constitu- 
tional, clinically  demonstrated,  action  of  the  discharges 
from  vacuum  tubes  may  be  largely  attributed.  When, 
however,  the  application  is  made  to  the  surface  of  the 
body,  either  with  the  patient  holding  an  electrode  con- 
nected with  the  resonator,  or  when  the  electrode  is  applied 
without  such  contact,  the  patient  receives  inductively  and 
conducts  from  the  surrounding  capacity  to  the  point  of 
discharge  currents  of  equal  potential  of  the  opposite 
polarity  throughout  the  tissues  of  the  body  from  the 
p«'iphery  to  the  electrode. 

(2)  The  rubefacient  effects  of  these  discharges  are  pro- 
nounced in  character,  and  when  excited  by  the  vacuum 
tube  held  a  short  distance  from  the  surface  or  from  the 
spark  of  the  resonator,  they  produce  a  marked  degree 
of  local  counter  irritation  and  more,  because  the  local  ef- 
fects of  these  discharges  are  clinically  demonstrated  to  in- 
fluence metabolic  processes  in  the  integument,  restoring, 
to  a  remarkable  degree,  normal  conditions.  The  action 
may  be  carried,  however,  so  far  as  to  produce  distinctly 
cauterant  effects. 

They  may  be  so  administered  as  to  cauterize  the  tissues 


VACUUM  TUBES  (33 

from  almost  any  source,  the  time  required  varying  with 
the  am})erage  of  the  current,  other  things  being  e(iunl. 
That  this  action  should  be  considered  as  comparable  to 
the  X-ray,  as  one  author  has  suggested,  is  a  serious  mis- 
take. That  necrotic  conditions  are  exerted  by  both  is  ad- 
mitted, but  as  well  say  that  the  application  of  an  actual 
cautery  produces  the  same  effects  as  the  X-ray  when  they 
arise  from  entirely  different  conditions. 

(3)  The  antiseptic  action  of  these  discharges  is  due  to 
the  influence  of  the  chemical  products  of  the  discharges 
produced  by  the  passage  of  electricity  through  the  air- 
gaps,  and  the  action  of  the  actinic  rays  associated  with 
the  diseharjjcs.  The  radiations  Iiave  been  reported  by 
various  authorities  as  penetrating  the  tissues  from  one  to 
three  millimeters.  They  are  peculiarly  etfective  in  the  de- 
struction of  germs  which  are  susceptible  to  the  influences 
of  light,  as  are  the  gonococci.  The  extent,  however,  of  the 
antiseptic  action  has  not  been  fully  demonstrated.  The 
chemical  effects  of  the  products  of  atmospheric  and  elec- 
tric decom])osition  are  fairly  energetic,  when  brought  in 
close  relation  with  the  tissues,  as  when  vacuum  tubes  are 
placed  in  the  cavities  of  the  body,  when,  to  obtain  the  best 
results,  the  glass  should  be  large  enough  to  smooth  out 
the  rugip  of  the  mucous  membrane  in  order  to  bring  the 
discharges  in  immediate  contact  with  the  germs  that  may 
be  present.  The  nascent  nitrous  acid  (NO,)  is  i)roduced 
in  such  infinitesimal  jiarticles  that  even  when  it  imme- 
diately unites  with  the  water  (H,0)  present  and  forms 
nitric  acid  (H,  NO,),  it  is  not  in  sufficient  quantity  to  cause 
disagreeable  irritation  to  the  tissues  unless  the  adminis- 


64  HIGH-POTENTIAL  CURRENTS 

trations  are  prolonged.  The  time  of  application  may  be 
varied,  however,  from  five  to  fifteen  minutes  according  to 
the  amperage  of  the  current  employed.  The  current  of 
larger  amperage  produces  a  much  richer  discharge  and 
consequently  one  which  is  productive  of  a  greater  degree 
of  chemical  effect. 

(4)  The  analgesic  action  is  due  largely  to  the  effect 
upon  local  inflammatory  conditions.  There  is  also  an 
anaesthetic  or  numbing  influence  upon  the  superficial 
tissues,  which  relieves  to  a  large  extent  local  irritability, 
and  by  causing  an  ulcerated  surface  to  become  super- 
ficially covered  with  a  glossy  film  (resembling  a  coating 
of  collodion)  which  remains  after  the  applications, 
thereby  protects  the  surface  from  local  irritation. 

(5)  The  effects  upon  local  metabolism  are  due  largely 
to  the  induction  of  muscular  and  tissue  contraction  and 
the  vibratory  influences,  coincidently  affecting  local  stasis 
and  congestion.  These  effects  are  most  marked  when  the 
vacuum  electrodes  are  in  contact  with  the  tissues,  and  the 
current  is  produced  by  direct  connection  with  the  static 
machine  (with  coil  currents  active  contraction  is  not  pro- 
duced). By  this  means  existing  induration  and  infiltra- 
tion are  dissipated,  the  tissues  become  softened,  and  the 
circulation  is  restored  as  to  the  margin  of  an  ulcer  and 
local  repair  is  instituted.  The  same  influence  produces  an 
increased  elimination  of  the  products  of  inflammation, 
thereby  assisting  the  process  of  reconstruction.  Conges- 
tion is  relieved  and  restoration  of  ulcerated  and  indurated 
regions  to  a  normal  condition  is  effected,  in  cases  which 
are  not  malignant  or  too  chronic  or  deeply  seated  in  char- 


VACUUM  TUBES 


65 


aeter.  When  application  is  made  repeatedly,  with  vac- 
uum-tube discharges,  to  the  surface  of  the  body,  the  skin 
beneath  the  epithelium  becomes  pigmented,  a  condition 
which  may  persist  for  considerable  time,  but  is,  as  a  rule, 
finally  absorbed  as  is  tanning  by  the  sun's  rays,  to  which 
it  is  analogous. 

(G)  Aluscithir  and  tittsuc  contraction  and  local  pulsation 
are  priKlucnl  by  these  vacuuiii-tuhe  discharges  to  a 
marked  degree  when  derived  directly  from  one  side  of  the 
static  machine,  when  a  spark  in  the  circuit  is  discharging 
at  the  spark-gap.  These  effects  of  muscular  and  tissue 
contraction  and  local  vibration,  so  valuable  in  therapeu- 
tics for  the  production  of  increased  local  metabolism  and 
elimination,  as  well  as  the  restoration  of  muscular  tone, 
are  not  so  well  produced  by  connection  in  any  other  man- 
ner or  to  any  other  apparatus  that  has  been  produced,  as 
to  the  static  machine  in  the  manner  above  described.  It 
should  be  understood  that  it  is  not  necessary  that  the  pa- 
tient be  insulated  during  the  administration  of  this  mo- 
dality. 

The  muscular  contraction  and  vibration  produced  in 
the  above  manner  is  greatly  accentuated  by  grounding 
the  opposite  side  of  the  machine — the  one  not  connected 
to  the  patient.  Muscular  and  protoplasmic  contractions 
reflex  in  character  may  also  be  induced  by  convective 
discharges  when  applied  to  the  surface  from  the  tube  held 
at  a  short  distance.  The  sparks  administered  from  a  res- 
onator, or  solenoid,  either  with  a  coil  or  static  machine, 
will  produce  marked  muscular  and  protoplasmic  con- 
traction. 


66  HIGH-POTENTL\L  CURRENTS 

The  indications  for  superficial  application  are  for  the 
treatment  of  local  skin  and  superficial  inflammatory  af- 
fections. The  administration  of  the  coil  or  resonator  cur- 
rents from  the  vacuum  tubes  in  close  contact  with  the  tis- 
sues produces  to  a  very  slight  extent,  if  any,  appreciable 
muscular  contraction,  and  they  are  not  sufficiently  ener- 
getic to  be  of  therapeutic  value. 

There  is  a  marked  contraction  of  superficial  cell  proto- 
plasm from  the  resonator  sparks  from  either  of  these 
sources,  and  owing  to  the  larger  amperage  of  current,  this 
is  more  marked  in  a  given  length  of  time  from  the  coil 
than  from  the  static  machine.  The  etfect  of  this  modality 
makes  the  coil  current  valuable,  also,  in  the  treatment  of 
superficial  inflammatory  conditions. 

Those  who  employ  coils,  as  shown  in  the  reports  of  re- 
sults in  the  writer's  possession,  obtained  from  numerous 
observers  employing  vacuum  tubes,  are  having  a  smaller 
percentage  of  success  from  the  treatment  of  inflammatory 
conditions — either  those  employing  the  coil  or  static  cur- 
rents from  resonators — than  those  who  employ  the  cur- 
rent directly  from  one  side  of  a  static  machine,  employing 
the  usual  grounding  to  the  opposite  side.  In  this  connec- 
tion it  should  be  emphasized,  then,  that  whenever  it  is  de- 
sirable to  produce  this  etfect  of  tissue  and  muscular  con- 
traction and  vibration  for  the  relief  of  local  inflammatory 
conditions,  the  current  should  not  be  derived  from  a  res- 
onator or  step-up  coil,  but  when  possible  directly  from  the 
static  machine,  one  side  of  which  is  provided  with  a  good 
metallic  grounding.  This  is  an  important  observation  in 
connection  with  the  application  of  vacuum  tubes  and  is 


VACUUM  TUBES  67 

the  indication  for  the  choice  of  methods  for  the  treatment 
of  non-malignant,  suppurating,  or  tubercular  conditions 
when  not  too  deeply  seated.  The  latter  demand  the 
more  energetic  modalities — the  wave-current  or  indirect 
sparks. 

(7)  The  local  production  of  heat  arising  from  the 
action  of  the  current  is  due  to  the  chemical  inHuence  of 
the  discharges  in  the  very  minute  air-spaces  which  exist 
in  the  tissues,  and  to  the  eifect  of  the  heating  of  the  glass 
from  the  i)assage  of  the  discharges.  Some  heat  is  also, 
undoubtedly,  produced  by  the  passage  of  the  current 
through  the  tissues  and  is  insignificant  or  marked,  rela- 
tive to  the  amperage  employed. 

The  thernpeiitic  indications  for  the  employment  of  the 
vacuum  tubes,  as  suggested  by  the  foregoing  physical  and 
physiological  effects,  is  important,  especially,  for  the 
treatment  of  superficial  skin  conditions  and  ulcerative 
and  inflammatory  processes  in  the  cavities  of  the  body. 

(1)  For  the  relief  of  superficial  local  congestion  and 
induration,  as  suggested  above,  satisfactory  results  are 
obtained.  The  method  is  especially  adapted  to  affections 
of  the  mucous  surfaces  and  is  usually  administered  by 
applying  the  vacuum  tubes  in  close  contact  with  the  tis- 
sues. The  current  of  the  static  machine,  when  (Mni)loyed 
in  these  cases  as  the  source  of  the  high-potential  current, 
accomplishes  the  best  results.  Those  who  em]>loy  coils 
may  obtain  excellent  results,  though  not  ecjually  good, 
from  the  use  of  the  vacuum  tubes  in  these  conditions. 
AVitli  the  static  machine  these  vacuum  tubes  may  be  used 
either  as  described,  connected  directly  to  one  side  of  the 


68  HIGH-POTENTIAL  CURRENTS 

Holtz  machine,  the  opposite  side  being  grounded,  or  it  will 
be  found  convenient  in  many  cases,  and  equally  good  re- 
sults may  be  obtained  by  connecting  it  directly  with  the 
outer  coating  of  one  of  the  Leyden  jars,  when  using  the 
static  induced  current.  A  metal  electrode  may  then  be 
placed,  if  desirable,  upon  one  part  of  the  body  of  the  pa- 
tient, and  the  vacuum  tube  in  position  in  the  rectum  or 
vagina,  or,  if  desirable,  two  vacuum  tubes  may  be  used 
simultaneously.  When  this  is  done,  either  with  one  metal 
electrode  or  two  vacuum  tubes,  the  local  effects  may  be 
regulated  by  varying  the  sizes  of  the  Leyden  jars,  which 
are  connected  to  the  two  electrodes;  for  example,  if  a 
metal  plate  has  been  placed  upon  the  abdomen,  or  over  the 
liver  of  the  patient,  and  another  one  in  the  rectum  for 
the  treatment  of  a  local  condition  in  that  region  and  the 
machine  started.  (See  Plate  IV.)  When  regulating 
the  current  to  the  demands  of  the  case,  a  distinct  vi- 
bratory effect  should  be  appreciated  in  the  rectum.  If  to 
induce  this  effect  too  great  muscular  contraction  is  pro- 
duced beneath  the  metal  plate  which  has  been  placed  upon 
the  abdomen,  a  smaller-sized  Leyden  jar  should  be  placed 
upon  the  side  to  which  the  cord  connected  with  the  elec- 
trode on  the  abdomen  is  attached,  or  a  larger  one  may  be 
placed  upon  the  other  side  and  a  shorter  spark-gap  em- 
ployed. By  using  the  three  sizes  of  Leyden  jars  provided 
with  static  machines  and  varying  them  to  suit  the  condi- 
tions, it  will  often  be  possible  to  produce  desirable  local 
conditions  without  discomfort  to  the  patient.  By  vari- 
ously regulating  the  application  of  the  current,  two 
patients  may  be  treated  at  the  same  time  with  the  static 


VACUUM  TUBES  69 

induced  current,  ii"  it  should  be  desirable  to  do  so  for 
economy  of  time. 

Another  method  of  producing  muscular  contraction  for 
the  relief  of  local  congestion — the  method  which  is  em- 
ployed successfully  to  the  surface — is  to  apply  the  sparks 
from  a  high-potential  resonator  in  connection  with  a  coil 
or  static  machine.  The  application  of  these  short  sparks, 
from  either  source,  should  be  made  to  the  parts  affected, 
but  should  never  be  made  too  painful.  For  using  this 
method  with  either  high-potential  resonators  or  solenoids, 
the  apparatus  should  be  capable  of  delivering  sparks  one- 
half  to  one  and  one-half  inches  in  length.  These  may  as 
well  be  applied  when  using  a  static  resonator  from  a  small 
brass  ball,  when  the  sparks  are  more  energetic.  The  effect 
of  contraction  from  these  applications  is  most  marked^ 
especially  of  cell  protoplasm,  the  tissues  taking  on  a 
condition  of  marked  contraction  expressing  serous  con- 
tents from  the  cedematous  tissue  or  pustule,  thereby  ren- 
dering a  valuable  service  in  the  treatment  of  various  skin 
conditions.  These  a^iplications  are  valuable  in  the  treat- 
ment of  felons,  tonsilitis,  and  other  abscesses  in  the  early 
stages;  for  the  relief  of  congestion  in  the  small  joints,  as 
in  cases  of  the  treatment  of  rheumatoid  arthritis,  for  the 
production  locally  of  small  blisters,  for  the  removal  of 
moles  and  freckles,  and  in  the  treatment  of  numerous  skin 
diseases,  notably  the  types  of  lu])us,  eczema,  su])erficial 
ulcers,  angiomas,  etc. 

(2)  For  the  restoration  of  normal  secretion  in  the  skin 
and  mucous  cavities  to  which  the  application  is  made, 
these  high-potential  modalities  are  valuable.    The  same 


70  HIGH-POTENTIAL  CURRENTS 

rule  obtains  here  as  in  the  treatment  of  inflammatory 
conditions  with  reference  to  the  production  of  local  tis- 
sue contraction  and  vibration,  the  vacuum  tubes  with 
static  current  and  relatively  painless  resonator  sparks, 
static  or  coil,  producing  the  best  results. 

(3)  To  relieve  excessive  secretion,  restoring  tonic  con- 
ditions to  the  tissues  by  the  production  of  contraction 
of  cell  protoplasm  with  the  expression  of  redundant  se- 
cretions such  as  are  found  in  eczema,  no  measure  is  more 
valuable  than  the  short  resonator  sparks  applied  exten- 
sively over  the  affected  region.  The  parts  will  continue 
to  ooze  for  a  considerable  time  after  the  cessation  of  the 
administration,  so  that  subsequently  the  reduction  of  the 
oedema  will  be  marked.  For  the  increase  of  superficial 
local  metabolism  the  application  of  the  resonator  sparks 
is  effective  by  the  induction  of  vibration  and  muscular 
contraction. 

The  relief  of  swelling  and  induration  and  institution 
of  tissue  repair  are  remarkably  demonstrated  in  the  treat- 
ment of  ulcerations  of  accessible  mucous  cavities.  The 
administrations  are  especially  valuable  in  the  treatment 
of  various  ulcerative  and  congested  conditions  in  the  cav- 
ities of  the  body  with  the  vacuum  tube  in  contact  with  the 
affected  areas.  Externally  the  application  of  the  short 
resonator  sparks  p'roduced  by  the  so-called  high-potential 
apparatus,  alone  or  in  connection  with  a  solenoid,  are  to 
be  preferred  if  the  vacuum  tubes  are  to  be  employed. 

(4)  To  the  treatment  of  local  specific  conditions  in 
which  the  parts  affected  are  superficially  located,  no  mo- 
dality affords  better  promise  of  success  than  the  small 


VACUUM  TUBES  71 

resonator  spark,  either  from  the  vacuum  tube  or  a  metal 
or  carbon  electrode.  In  the  treatment  of  these  conditions 
the  necessity  for  a  current  which  will  i)roduce  muscular 
contraction  and  vibration  is  not  so  important.  Where 
conditions  of  impaired  metabolism  are  present,  vibratory 
and  contraction  effects,  however,  do  promote  the  elim- 
ination of  effete  and  toxic  materials,  and  increase  local 
leucocytosis,  thereby  facilitating  the  restoration  of  nor- 
mal conditions.  The  antiseptic  effects  are  due,  as  ex- 
plained above,  to  the  chemical  products  of  the  discharges, 
as  they  are  produced  in  the  interstices  in  the  su])erficial 
structures  by  the  decomposition  of  gases,  to  the  action  of 
the  rays  of  light  upon  the  tissues  and  the  germs,  to  which 
in  many  cases  they  are  destructive,  and  to  the  increased 
resistance  of  the  tissues.  By  these  methods  the  processes 
which  are  acting  as  local  sources  of  irritation  are  de- 
stroyed and  reparative  action  instituted. 

(5)  The  cataphoric  action  of  the  vacuum-tube  dis- 
charges when  the  tubes  are  ]ilaced  in  close  relation  to  the 
tissues,  or  from  the  a])])lication  of  the  resonator  si)arks, 
has  been  demonstrated  by  Drs.  Francis  B.  Bishop  and  J. 
H.  Burch,  and  may  be  verified  by  anyone  who  wishes  to 
make  the  experiment.  The  extent,  therefore,  to  which  this 
sort  of  action  is  valuable,  is  one  open  to  careful  study. 
The  indication  for  the  use  of  iodine  or  other  local  germi- 
cides in  the  treatment  of  specific  conditions  will  depend 
ujion  the  failure  to  succeed  by  simj)ler  methods.  Failing  to 
relieve  the  conditions  by  the  a])plication  of  high-potential 
discharges  alone,  it  will  ('crtniiily  be  ]iro})er  and  scientific 
to  resort  to  tiie  emplojTnent  of  cataphoric  methods,  mild 


'/O 


HIGH-POTENTIAL  CURRENTS 


though  they  be.  Marked  success  has  been  obtained  in  the 
treatment  of  Riggs '  disease  by  this  method. 

(6)  For  the  relief  of  pain,  the  same  general  principles 
obtain  as  for  the  relief  of  inflammatory  conditions,  with 
the  advantage  also  that  these  applications  produce,  as 
stated  above,  a  coating  upon  the  outside  of  the  surface 
due  to  the  contraction  of  the  superficial  protoplasm.  This 
effect  in  a  large  measure  resembles  a  coating  of  collodion 
which  protects  the  ulcerated  surface  against  irritating 
secretions.  Conditions  of  neuralgia,  arising  from  im- 
paired elimination  of  toxins,  due  to  various  causes,  may 
be  relieved  by  either  general  or  local  applications  of  these 
modalities.  For  the  improvement  of  local  metabolism, 
these  and  other  high-potential  methods  of  application 
afford  a  valuable  means.  For  the  effects  upon  general 
metabolism  local  applications  of  this  sort,  however,  are 
not  of  nearly  so  great  value  as  other  methods  of  applying 
these  currents. 

The  field  of  indications  for  the  employment  of  vacuum- 
tube  discharges  as  suggested  is  large  indeed  and  worthy 
of  general  recognition  by  the  medical  profession. 


SECTION   II 


HIGH  FREQUENCY  MODALITIES 

AND 

APPARATUS 


SECTION  II 

HIGH  FREQUENCY  CI  RRENTS 
AND  APPARATUS 

CHAPTER  I 

COMPARISON    OF    CUKUENTS    OF    HIGH    FUEQUEXCY   AND   HIGH 

PERIODICITY 

Thk  professional  understanding  of  high  potential  cur- 
rents of  high  frequency  and  high  periodicity,  is  so  vague 
in  the  minds  of  the  rank  and  file,  as  to  the  exact  quality 
or  character  of  current  considered  under  the  designation, 
that  the  writer  will  attempt  to  make  clear  the  relationship. 

The  Committee  on  Current  Classification  and  Nomen- 
clature consisting  of  thi'  distinguished  physicists  Dr.  A.  E, 
Kennelly,  Prof.  Eliliu  Tliomi)st)n,  Dr.  Samuel  Shehlon, 
l»rof.  William  Uerdman,  :M.  D.,  Mr.  W.  J.  Jenks,  and  Mr. 
Charles  L.  Clarke,  in  their  report  before  the  American 
Electro-Therapeutic  Association  in  1004,  on  page  81  of 
the  published  reports  of  the  Committee,  fully  outlined  and 
dcfiniHl  the  conditions  under  which  oscillatory  currents 
and  pulsatory  currents  are  pnnluced. 

An  oscilhitonj  current  is  defined  in  the  report  of  Jonks 
and  Clarke  ius  "A  current  which  periodically  flows  in 
opposite  directions,  but  not  necessarily  in  both  directions 
for  the  siime  length  of  time,  and  in  which  the  maximum 
valuers  or  amplitudes,  of  successive  waves  (irrespective 
of  the  direction  of  flow)  change  in  regular  order.  In  an 
oscillating  current  of  so-called  jMirc  sine  wave  form,  the 

73 


74  HIGH-POTENTIAL  CUREENTS 

current  flows  in  successively  opposite  directions  for  the 
same  length  of  time,  and  the  amplitudes  of  successive 
waves  bear  to  each  other  a  constant  ratio ;  that  is,  so  vary 
that  from  beginning  to  end  of  the  oscillations  each  fol- 
lowing amplitude  bears  the  same  ratio  to  the  next  pre- 
ceding amplitude.  Fig.  14,  represents  an  oscillating  cur- 
rent of  pure  sine  wave  form  consisting  of  a  series  of 
waves  of  constant  length,  decreasing  in  amplitude  or 
strength,  in  constant  proportion." 


Fig.  14.     Illustrating  an  Oscillatory  Impulse. 

A  current  to  be  designated  a  high  frequency  current, 
must  have  a  high  rate  of  alternation.  In  a  completed  cycle 
each  wave  crosses  the  neutral  line,  completing  a  double 
curve  from  a  neutral  line  across  that  line  and  back,  mak- 
ing a  complete  sine  wave  as  of  the  sinusoidal  current  which 
is  an  alternating  current  of  uniform  cycle. 

The  term  high  frequency  current  approximately  desig- 
nates a  rate  of  oscillation  exceeding  10,000  per  second, 
at  w^hich  point  muscular  response  or  contraction  ceases, 
and   run    as    high    as   millions   per    second.      An    appa- 


C0M1»AUI80X  OF  CURRENTS 


75 


ratus  to  produce  a  current  of  tliis  character,  must  derive 
a  current  from  a  source  of  hijj:li  potential — a  static 
machine,  Ruhmkorff  coil  or  transformer — which  is  oper- 
ated in  association  witli  a  resonator,  consisting  of  con- 
densers in  arrangement  with  solenoids  as  elsewhere 
described. 

The  oldest  type  of  alternating  current  apparatus  was 
manufactured  for  therapeutic  pui*poses  in  1848  by  the 
Jerome  Kidder  Co.  of  New  York,  as  shown  in  Fig.  15. 


Fig.  15.     Jerome  Kidder  ^^apneto. 

This  electro  magnetic  apparatus,  antedated  the  alternat- 
ing current  dynamo  and  the  sinusoidal  machine  as  later 
constructe<l.  This  type  of  apparatus  may  be  pointed  to 
as  the  father  of  the  present  type  of  great  generating 
dynamos.  While  this  apparatus  produced  a  distinctly 
alternating  cai*rent,  .such  as  the  sinu.soidal  current  now 
produced  by  the  more  modern  apparatus,  the  potential  was 
low  and  the  effects  painful  and  disagreeable. 

The  typ<'  of  arrangement  which  first  produced  currents, 
that  were  correctly  designated  as  high  frefjuency  currents, 
was  the  static  induced  current  as  previously  d<'.scribed, 
and  first  published  by  Dr.  William  James  Morton  of  New 


76  HIGH-POTENTIAL  CURRENTS 

York  in  1882.  The  oscillations  produced  by  the  spark- 
gap  in  the  arrangement  of  this  current  (See  Fig.  4),  were 
the  first  so  recognized  oscillatory  currents  of  high  fre- 
quency. 

A  modification  in  the  arrangement  of  this  current  was 
made  by  Prof.  d'Arsonval  which  consisted  in  connecting 
the  outer  coatings  of  the  two  Leyden  jars  with  the  two 
ends  of  a  solenoid. 

By  this  arrangement  when  the  current  from  the  two 
poles  of  either  a  static  machine,  coil  or  other  transformer 
is  caused  to  pass  to  the  inner  side  of  the  tw^o  Leyden  jars, 
and  when  an  arrangement  with  a  controllable  spark-gap 
provision  is  made  for  interrupting  the  circuit,  oscillations 
are  set  up  in  the  solenoid  connecting  the  two  outer  coats 
of  the  Leyden  jars  or  other  condensers.  Connections 
tapped  off  from  the  two  ends  of  the  solenoid  or  from  any 
of  the  intervening  turns  convey  a  high  frequency  current 
of  relatively  low  voltage  and  high  frequency,  and  a  current 
of  a  larger  amperage  or  heat  producing  quality  than 
currents  produced  by  other  arrangements  (see  Fig.  16). 
By  this  arrangement  it  is  possible  to  vary  the  current 
strength  by  increasing  the  speed  of  the  static  machine, 
or  regulating  the  resistance  in  the  circuit  between  the 
street  current  and  the  transformer  and  adjusting  by 
lengthening  or  shortening  the  spark-gap.  It  is  also  pos- 
sible by  varying  the  length  of  the  spark-gap  and  the 
additional  resistance  in  the  circuit,  when  placing  the 
cushion  between  the  patient  and  the  metal  condenser. 
When  the  patient — a  capacity — is  then  connected  with  the 
other  terminal  of  the  solenoid,  the  current  is  converted 
into  a  practically  unidirectional  current  of  high  periodicity 
as  was  clearly  set  forth  in  the  report  of  Jenks  and  Clarke 


COMPARISON  OF  CURKENTS  77 

ill  till'  CDiiimittei'  rt'j)ort  referred  to,  pages  83  to  95.  The 
oscillations  are  damped  down  by  the  resistance  of  the 
cireiiit,  to  the  ext*^nt  tiiat  the  predominajit  strength  of  the 
current  is  flowing  in  one  direction,  losing  to  such  a  large 
degree  its  oscillatory  character,  that  the  current  becomes 
practically  «  unidirectional  current  of  high  periodicity. 
In  other  words,  a  high  frequency  oscillat4)rj'  current  in 
which  the  sine  waves  of  either  side  of  the  neutral  line 
are  approximately  e<iual  is  to  such  an  extent  damj>ed  out 
that  the  alternating  quality  is  changed  to  that  of  a  uni- 
directional current  of  high  periodicity.  In  other  words 
a  current  produced  by  the  same  apparatus  by  varying  the 
resistance  or  spark-gap,  and  capacity  and  the  resistance  of 
the  couch  cushion  added  to  the  resistance  of  the  skin  of 
the  hands  and  arms  of  the  patient,  his  body  being  the 
capacity,  is  converted  into  a  pulsatory  current — unidirec- 
tional in  character — of  high  periodicity.  Definitely  stated, 
a  high  frequency  current  is  oscillatory  and  alternating; 
and  a  current  of  high  periodicity  is  pulsatory  and  unidi- 
rectional. 

A  distinct  type  of  pulsatory  current  is  the  static  wave 
current,  which  is  also  to  the  greatest  extent  unidirectional. 
The  current  however,  from  a  resonator  under  the  condi- 
tions stated,  in  the  preceding  paragraph,  also  becomes 
practically  unidirectional  and  pulsatory.  This  may  be 
readily  demonstrated  by  holding  in  the  hands  a  vacuum 
tube  of  fairly  high  vacuum  one  end  of  wliich  is  in  contact 
with  the  body  of  a  patient,  seatinl  upon  an  auto-condensa- 
tion couch  and  ccmnecttnl  in  a  d'Arsonval  circuit.  When 
contact  is  made  under  these  conditions  with  the  patient 
connected  to  the  positive  side  of  a  resonator  a  green 
fluorescence  will  immediately  appear  at  the  patient's  end 


78 


HIGH-POTENTIAL  CURRENTS 


of  the  tube,  the  cathode  stream  of  negative  electrons,  pass- 
ing to  the  point  of  contact  with  the  patient's  body,  results 
in  a  production  of  the  x-ray  which  causes  the  green  fluor- 
escence. Reverse  the  poles  and  the  fluorescence  occurs 
at  the  opposite  end  of  the  tube. 

The  differences  as  to  variations  of  conditions  and  effects 
arising  from  changes  in  the  circuit,  require  consideration 
for  therapeutic  reasons,  particularly  so  if  the  currents 


Fig.  16.     d'Arsonval  Current. 


are  to  be  employed  conductively  for  effects  upon  nutri- 
tion and  metabolism.  These  will  be  considered  in  a  sub- 
sequent chapter.  When,  however,  a  current  is  employed 
for  the  induction  of  hyperemia,  either  by  means  of  the 
thermic  effects  of  the  current,  or  by  the  superficial  stimu- 
lating effects  of  the  discharges  from  the  effleuves  or 
vacuum  tubes  to  the  skin,  it  will  be  relatively  alternating, 


COMPARISON  OF  CURRENTS 


79 


though  not  to  the  same  degree  as  the  d'Arsonval  luiiuin- 
istration  by  the  direct  method  wliea  the  current  passes 
directly  through  the  tissues  of  the  patient  without  other 
resistani'e. 

Coufusion  is  apt  tu  vdist  in  the  mind  of  the  student  as 
to  the  relative  quality  and  indications  for  the  employment 
of  the  various  high  frequency  modalities,  particularly  of 


Fig.    17.     Arrangement   for  Auto-Condensation. 
A.  Dialettric;   B,  Metal  Plate;  C,  D,  E,  Points  of  greatest  Condensation. 


the  d'Arsonval,  Tcshi  and  Oudin  currents.  It  seems 
that  those  who  are  not  informed  are  lial>U'  to  consider 
these  currents  much  as  they  do  certain  drugs  of  the  phar- 
niJieopoeia ;  as  producing  distinctly  4linerent  therajHMitic 
etTrrts,  and  possessed  of  distinctly  ditferent  qualities  of 
action,  which  is  generally  not  so.  Variations  in  enrrent 
strength  or  amix'rage  and  potential  or  voltage,  together 
with  tlir  characteristics  of  tlie  current  as  U^  frequency  or 


80 


HIGH-POTENTIAL  CURRENTS 


periodicity,  are  the  differences  generally  to  be  considered 
in  treating  with  these  modalities. 

The  static  induced  current,  the  first  of  the  high  fre- 
quency currents,  is  considered  in  Chapter  III,  Section 
II  of  this  work   (q.  v.). 

The  d'Arsonval  current,  Fig.  16,  produced  under  the 
peculiar  conditions  of  arrangement  as  shown  in  the  cut, 
is  the  current  of  largest  amperage  and  lowest  potential 
of  the  high  frequency  currents.    It  has,  consequently,  the 


7 

o 


Fig.  18.     Arrangement  for  Tesla  Current. 


greatest  capacity  to  induce  heat  in  its  passage  through 
the  tissues,  and  at  the  same  time  produces  a  minimum  of 
other  disturbing  effects.  It  is  administered  to  the  patient 
either  upon  the  auto-condensation  couch  (Fig.  17),  or 
within  the  solenoid  by  the  method  of  auto-conduction 
(Fig.  45). 

The  Tesla  current  is  a  current  stepped  up  from  the 
d'Arsonval ;  i.  e.,  a  current  in  which  the  voltage  has  been 
raised  by  passing  it  through  a  second  solenoid  at  the 
expense  of  the  amperage.    It  comprises  a  completely  insu- 


COMPARISON  OF  CURRENTS 


81 


lated  and  unconnected  solenoid,  either  within  or  surround- 
ing a  d'Arsonval  solenoid  (see  Fig.  18).  The  resulting 
current  as  stated  is  reduced  in  amperage  and  the  voltage 
is  increased.  The  variations  in  voltage  are  measured  by 
the  difference  in  the  length  of  spark  or  effleuve,  the  poten- 
tial of  delivery,  which  will  pass  to  a  capacity  when  brought 
into  the  field  of  the  discharge  as  compared  with  the  length 


UU 


Fio.  19.     Arrangement  for  Oudin  Current. 


of  the  discharge  from  the  d'Arsonval  circuit.  This  cur- 
rent, like  the  d'Arsonval  current,  is  administered  from 
two  terminals,  or  from  one  terminal  when  fi'oni  a  static 
machine  with  the  other  terminal  of  the  resonator  grounded, 
when  the  discharges  are  more  penetrating  and  stimulating 
in  character.  The  effect  of  grounding  one  side  of  the 
Tesla  is  very  different  when  the  apparatus — the  resonator 
— is  in  connection  with  a  Iloltz  machine  than  with 
the  Ruhmkorff  coil  or  other  transfonner.     The  current 


S2  HIGH-POTENTIAL  CURRENTS 

from  the  static  macliine  is  rendered  very  similar  in  effect 
to  the  Oudin  current  from  the  same  source,  when  one 
side  of  the  Tesla  is  grounded. 

The  Oudin  current  is  produced  with  a  solenoid  con- 
nected to  one  end  of  a  Tesla  or  d'Arsonval  solenoid,  and 
operated  with  an  electrode  attached  to  the  solenoid; 
and  the  current  is  properly  speaking  a  one  pole  current, 
the  circuit  being  completed  through  the  body  of  the 
patient,  which  acting  as  a  capacity,  stores  and  con- 
ducts the  opposite  polarity  to  the  discharging  electrode. 
The  current  may  be  varied  in  the  quality  of  the  oscillations 
under  varying  conditions  of  regulation  of  the  spark-gap 
and  control  of  the  current  which  passes  into  the  resonator, 
and  the  character  of  the  grounding  (see  Fig.  19). 

When  employed  in  connection  with  the  static  machine 
the  Oudin,  as  with  the  Tesla  current,  discharges  a  pulsa- 
tory current  the  pulses  of  which  are  synchronous  with 
the  discharges  from  the  Ley  den  jar  at  the  spark-gap  with 
a  more  positive  and  marked  effect  than  when  discharged 
from  the  solenoid  connected  with  a  coil  or  transformer. 

These  modalities  will  be  treated  in  separate  chapters 
but  are  here  considered  for  the  purpose  of  showing  the 
differences  as  to  the  quality  and  character  of  the  current 
produced. 

The  variations  in  quality  of  the  currents  of  high  fre- 
quency and  high  periodicity  must  be  considered  from  the 
standpoint  of  the  physical  effects  produced  which  depend 
upon  the  method  of  administration  and  the  variations  in 
current  strength  and  potential  employed.  It  should  be 
understood,  that  the  current  strength  and  potential  can 
be  varied  with  any  of  these  modalities,  either  by  varying 
the  spark-gap  in  the  resonator,  or  the  speed  of  the  static 


COMl'AIMSnX  or  cruiiENTs  83 

machine,  or  the  amouiit  of  ciii'i-ent  allowed  to  pass  into 
the  primary  of  the  Klmiiikortr  eoil  or  other  transformer. 
It  will  then  l»e  understood  that  the  variations  in  the 
matter  of  eurrcnt  streniitii  and  iiotcnt i;il  is  uiidci"  (•ontr<d 
of  The  operator;  and  that  under  tlu's<'  conditions  a  cur- 
rent may  he  j)ro<luced  in  a  d'Arsonval  circuit  which  under 
ditlerent  conditions  would  simulate  a  current  from  a 
Tesla  transformer.  Also  that  a  current  administered  from 
a  Tesla  or  d'Arsonval  from  one  pole  mijz;ht  be  varied  to 
produce  a  similar  etlect  if  it  is  discharged  from  an  Oudin 
under  varied  conditions.  It  is  necessary  then  to  study 
the  eti'ects  of  these  currents,  from  the  point  of  view  of  the 
amount  of  current  and  potential  acting  u]K)n  the  tissu'es; 
whether  the  d'Arsonval,  Tesla,  or  Oudin  is  employed ;  for 
the  character  of  effect  which  is  induced  under  varying  con- 
ditions from  either  of  these  nn)dalities  may  be  much  the 
same,  with  no  particular  advantage  in  either  case,  except 
when  extremes  indicate  a  greater  or  less  effect  to  be  pro- 
duced. The  effects  that  (ire  prodiiccil  witli  cnrreiits  of 
high  iK'riodicity  or  liigh  fre(|nen(y  are  ( 1)  tonic  effects,  or 
effects  ui)on  general  metal)olisni  and  nutrition;  (2)  hyper- 
emic  effects,  superficial  hyperemia  being  induced  by 
vacuum  tub<'s,  or  deeji  h}T)eremia  by  tli«'  tliennic  elTects 
of  pa.ssinga  high  fre<iuency  current  of  considerable  amper- 
age between  two  electrodes  ])laced  upon  the  body  at 
opposite  surfaces,  when  the  d'Arsonval  by  the  direct 
method  is  the  current  to  be  pn^ferred ;  l>ecause  with  a 
similar  potential  and  larger  aiiijierage  as  well  as  being 
a  more  conveni«»nt  method  of  administration,  the  current 
is  more  satisfactorily  produced.  Other  <'ffects  are  (3) 
local  skin  stimulation,  and  (4)  an  extreme  cauterant  or 
destructive  action  as  produced  by  the  method  of  Riviere 


84  HIGH-POTENTIAL  CURRENTS 

first  called  effluvation,  designated  by  Kaeting  Hart  under 
the  name  fulguration. 

For  the  induction  of  these  effects,  either  of  the  currents 
may  be  chosen,  preferably  the  d'Arsonval  or  Oudin  cur- 
rents which  meet  all  requirements.  The  currents  of  the 
so-called  "  Tesla  transformers  "  meet  the  last  two  indi- 
cations. 

The  methods  of  application  and  specific  indications  will 
be  specifically  considered  in  the  chapters  devoted  to  each 
of  the  modalities. 


CHAPTER  II 

APPARATUS 

The  different  types  of  apparatus  now  in  use  for  the 
production  of  currents  of  high  potential  of  high  frequency 
and  high  periodicity  are  the  Kulinikorff  coil  (oi>en  mag- 
netic circuit  transformer)  apparatus,  closed  magnetic 
transformer  with  condenser  or  motor  converter,  the  three 
types  of  static  machines,  Holtz,  Toepler  Holtz  and  Wims- 
hurst,  and  tlie  so-railed  Tesla  apparatus. 

Tlie  Ruhmkorff  coil.  Fig.  3t>.  In  comparing  the  different 
types  of  Ruhmkorff  coil,  we  have  to  consider  both  the 
method  of  winding  the  primary  and  the  construction  of 
the  secondary.  In  all  of  this  type  of  apparatus  a  large 
bundle  of  soft  iron  or  sheets  of  soft  iron  constitutes  the 
core  over  which  is  wound  the  primary  coil.  The  primary 
winding  may  be  of  (1)  the  series,  (2)  the  multiple  series, 
(3)  the  parallel  or  (4)  variable  inductance  con^struction. 

I7i  the  scries  there  is  a  continuous  winding  of  one,  two, 
three  or  four  layers  of  heaA-v-  copp<M'  wire  in  seriei*. 

In  the  multiple  series  the  windings  are  arranged  in  such 
a  manner  that  there  are  four  or  more  sections  connected 
in  such  a  way  that  part  of  the  current  passes  through  two 
of  the  st'ctions,  while  the  n'mainder  passes  through  the 
remaining  two  factions. 

The  parallel  consists  of  two  sections  of  primary  wind- 
ing, in  which  a  part  of  the  current  passes  through  each 
section. 

85 


86  HIGH-POTENTIAL  CURRENTS 

The  variable  inductance  primary  consists  of  a  long  con- 
tinuous winding,  tapped  out  at  different  points  in  such  a 
manner  that  the  current  will  pass  through  as  many  sec- 
tions as  are  brought  into  the  circuit  by  the  variable  in- 
ductance switch.  Any  one  of  these  primaries  can  be  used 
in  connection  with  any  of  the  different  types  of  secondary. 

The  secondary  of  the  Rhumkorf  transformer  or  coil, 
may  be  wound  in  the  bobbin  form,  which  consists  of  two 
long  sections  of  fine  wire  passed  over  the  primary  in  such 
a  position  as  to  be  brought  into  the  strongest  field  of  the 
magnetic  flux  set  up  in  the  primary. 

Another  method  of  icinding  is  the  so-called  wide  section 
secondary  which  consists  of  winding  I14  inch  across  each 
layer,  and  each  layer  separated  by  rings  of  paper.  A 
set  of  these  are  placed  over  the  primary,  and  connected 
in  series,  and  then  either  immersed  in  oil  or  semi-solid 
insulation.  The  third  type  which  is  by  far  the  most 
efl&cient,  is  the  thin  section  construction  which  consists 
of  flat  discs  of  14  inch  connected  in  series,  and  placed  over 
the  primary  in  such  a  position  as  to  receive  the  strongest 
magnetic  flux  from  the  entire  length  of  the  primary.  In 
order  to  accomplish  this  and  reduce  the  resistance  in  the 
secondary  winding,  the  end  is  wound  much  shorter  than 
those  in  the  central  portion. 

A  very  important  feature  in  the  construction  of  these 
coils  is  the  character  of  insulation  employed  particularly 
the  insulation  over  the  primary  core,  between  it  and  the 
secondary.  The  best  evidence  of  the  quality  of  construc- 
tion of  these  coils  is  the  character  of  guarantee  which  the 
manufacturer  is  willing  to  give  as  to  the  endurance  of 
the  apparatus. 

In  order  to  excite  the  Rhumkorff  coil,  it  is  necessary  to 


CUM I'AKl SOX   OF  (M'KinCNTS 


87 


use  some  fonn  of  intcrnipter,  and  tlio  onlinary  *'<iiiipiiHMit 
consists  of  the  voW,  intt'rru])t(*i",  rlHM>stat,  annnctcr  for 
nieasui'inj;  the  circnit  whicli  ]»ass('s  from  tlic  street  eircnit 
into  the  ]»i-iniarv,  and  in  ad<litinn  for  tlicraiMMitic  uses, 
the  proi)er  types  of  resonator  and  a  hot  w  ire  niilliampere- 
meter. 

The  different  types  of  iiitrrrnptt  rs  now  in  use  are  (1) 

1- " 


T3- 


^ 


^ 


Fiu.  -10.     Woliiu'lt  ]ntorni|>tor. 
A,  Positive  Connection  to  Line;   B,  Adjustinjij  Screw;   C,  Porcelain  Tube; 
D,  Platinum  Point;    E,   Negative  Connection  to  Line;   F,  Lead   Plate 
or  Spiral;  G,  Electrolyte  H,SO,  and  H,0  or  Mg.  S^  an<l  H,0. 

the  electrolytic,  (li)  nuM  hanical,  (ii)  mercury  jet,  and  (4) 
the  centrifugal. 

There  are  two  types  of  electrolytic  interrupter;  namely, 
the  Wehnelt  (Fig.  20),  ami  the  Caldwell;  the  former 
depending  upon  the  formation  and  the  breaking  of  a 
hubhh*  of  gas  arouml  the  platinum  point,  immersed  in  some 
form  of  electrolyU%  as  diluted  suljdiuric  aciij,  which  is  of 
high  electric  conductivity.     The  Cahlwell    (Fig.  21)    in- 


88 


HIGH-POTENTIAL  CURRENTS 


terrupter  depends  upon  forcing  the  bubbles  of  gas  through 
an  aperture  in  a  diaphragm,  having  an  electrolyte  and 
electrode  on  either  side,  each  electrode  being  connected  to 
the  two  opposite  poles  of  the  exciting  current  in  series 
with  the  coil  or  transformer. 
The  disadvantage  of  this  type  of  interrupter  for  use  in 


Fig.  21.     Caldwell  Interrupter. 
A  and  B,  Positive  or  Negative  Terminals;   C,  Lead  Plate  or  Spiral;   D, 
Porcelain  Beaker;  E,  Electrolyte;  F,  Aperture  Through  Beaker  (One 
or  More). 


connection  with  d'Arsonvalization  and  other  high  potential 
currents  is  the  fact  that  when  used  continuously  or  for 
long  treatments  the  fluid  becomes  heated,  and  must  be 
rested,  except  very  large  tanks  are  employed,  or  a  series 
of  interrupters.  Another  objection  is  that  the  irritating 
hydrogen  gases  evolved  in  the  process  of  interruption 
escape  into  the  atmosphere  of  the  room,  thereby  vitiating 


C0M1»AUIS0N  OF  CURRENTS 


89 


the  air,  as  evidenced  by  a  constant  disposition  of  those 
in  the  room  to  cough. 

There  are  several  types  of  mercury  jet  interrupters  all 
of  which  depend  upon  a  fine  stream  of  mercury  projected 
against  a  conductor  at  intervals,  the  conductor  being  con- 


FiG.  22.     Mercury  Jet  Interrupter. 
A,  Pulley  to  be  Driven  by  Motor;  B,  Terminal  Connecting  with  Mercury; 
C,   Insulated   Revolving   Contacts;    D,  Oil;    E,   Mercury;    F,   Terminal 
Connecting  with  Revolving  Contacts;  G,  Segments  Cut  Away  to  Show 
Jet  Tube;  H,  Mercury  Pump. 


nected  in  series  with  the  coil  and  part  of  the  apparatus 
which  delivers  the  stream  of  nicrcury.  The  objection  to 
these  interrupters  is  ;i  constant  disposition  of  the  mer- 
cury to  iM'comc  oxiilizctl  by  the  current,  requiring  frequent 
cleaning  if  much  used.  Tiiis  may  I)e  overcome  by  passing 
illuminating  gas  into  the  chamber  with  the  mercury. 
The  centrifugal   interrupter    (Fig.   23)    •consists   of   a 


90 


HIGH-POTENTIAL  CUEREXTS 


revolving  conductor  so  formed  that  the  mercury  is  forced 
into  a  groove  in  the  periphery  of  the  container,  in  which 
a  paddle  or  bar  of  metal  is  mounted  eccentric  to  the  shaft 
of  the  container,  and  an  insulated  external  connection 
brought  to  one  side  of  the  line  while  the  container  itself 
is  connected  through  the  primary  of  the  transformer,  and 


Fig.  23.       Centrifugal  Interrupter. 
A,  Connection  to   Eevolving  Contact;    B,  Insulating  Bushing;   C,   Oil;    D, 
Groove  for  Mercury;  E,  Lower  Bearing;   F,   Grooved  Pulley  for  Belt 
to  Motor;   G,  Chamber  Made  to  Eevolve;   H,  Mercury. 

thus  to  the  opposite  side  of  the  lines.  As  the  body  of  the 
interrupter  is  revolved,  the  mercury  is  forced  into  a  groove 
which  also  causes  the  paddle  to  revolve,  thereby  setting 
up  interruptions  in  the  circuit. 

The  same  objection — the  oxidation  of  mercury — prevails 
with  this  interrupter  as  with  the  mercury  jet  interrupter. 

The  mechanical  interrupter  (Fig.  24),  the  choice  of  in- 


COMPARISON  OF  CURRENTS 


91 


ternipters  for  therapeutic  purjxjses,  may  have  for  its  [>oint 
of  bi-eak  two  small  surfaces  of  j>latiiiiiiii  or  as  in  the  later 
types  the  platinum  points  as  used  are  usually  ojK'ratetl  by 
au  auxiliary  make  anil  break,  or  ori.uiually  the  eoutact  was 
actuated  on  the  well  known  vibration  principle  as  in  the 
primitive  "  Faradic  battery."  These  latter  were  calle<l 
vibrators  and  to-day  are  cpiite  satisfactory  in  small  bat- 
teries and  in  so-called  hiijh  tension  coils,  with  which  low 
volt  currents  are  to  be  used  for  certain  classes  of  treat- 


Fui.  24.     Mechanical  Interrupter. 
A,  CoDoections  for  Primary  of  Coil;  B,  Mapnct  Winding;  C,  Magnet  Core. 

ment.  There  is  one  great  advanta«,^e  in  all  of  the  so-called 
mechanical  interi'upter.s,  namely,  they  require  very  little 
attention  and  do  not  have  to  be  freinieiitiy  cleaned  and 
re-charged.  They  are  particularly  valuable  in  ciuinection 
with  the  therapeutic  employnuMit  of  high  p(>tential  cur- 
rents as  they  may  be  used  constantly  without  becoming 
overheate<l  or  re(iuiriiig  any  attention  whatever,  exc<'pt 
oiling  the  l)ejirings.  The  »cope  of  the  mechanical  inter- 
rupters having  the  motor  and  wide  contact,  however,  is 
much  broader  than  the  early  tyi>es  of  iuterruf)ter,  in  that 


92 


HIGH-POTENTIAL  CURRENTS 


the  larger  currents  can  be  used  and  very  satisfactory 
results  obtained  with  both  the  x-ray  tube  and  the  d'Arson- 
val  and  Oudin  currents.  The  only  attention  which  these 
require  is  an  occasional  oiling  of  the  motor  and  other 
moving  parts  together  with  the  proper  adjustment  of  the 
interrupter  to  the  work  in  hand. 


Fig.  25.     Closed  Magnetic  Circuit  Transformer. 


The  closed  magnetic  circuit  transformer — interrupter- 
less  transformers — (Fig.  25),  consists  of  a  soft  iron  core 
so  constructed  that  the  magnetic  flux  can  follow  a  course 
of  low  magnetic  resistance.  In  order  to  accomplish  this 
the  core  is  constructed  of  laminations  or  layers  of  soft 
iron  which  form  a  rectangle  or  square  with  the  corners 
built  up  in  such  a  manner  as  to  approach  complete  mole- 
cular or  metal  continuity  as  nearly  as  possible. 


COMPARISON  OF  CURRENTS 


93 


In  transforming  the  commercial  current,  engineering 
calculations  can  i-eadily  be  made  to  produce  any  desired 
potential  in  the  secondary  from  a  given  voltage  in  the 
primary  where  the  construction  of  the  core  is  such  that 
magnetic  leakage  and  resistance  are  reduced  to  a  mini- 
mum.    Therefore  the  magnetic  circuit  must  be  as  short 


^4- 


M 


\     /   (H»g'<'«'oleMTkil)  V  T 


fW 


WlndiMg 
lOO,ooo1o  2oo  OooV 


nsn 


Pig.  26.     High   Potential  Rotary  Rectifier. 


as  po.ssiltlc  ;m<l  the  magnetic  leakage  low,  to  a.<^sure 
accuracy  in  calculation.  This  method  of  generating  high 
potential  <'urrents  for  both  x-ray  and  high  p<>tential  thera- 
IK'Utic  purjH)S(.'s,  produces  most  .^itisfactnry  results  as  a 
much  longer  range  of  effects  can  be  produced,  and  at  the 
same  time  a  nun  li  larger  output.  Th(Te  has  been  ditTi- 
culty   however  in   constructing  this   type    of    apparatus, 


94  HIGH-POTENTIAL  CURRENTS 

owing  to  the  fact  that  it  is  difficult  to  properly  insulate 
the  secondary  and  at  the  same  time  produce  sufficient 
voltage  for  the  purpose  intended.  This,  however,  has  been 
to  a  great  extent  overcome,  and  transformers  are  now 
being  constructed  which  meet  the  requirements  admirably. 

The  introduction  of  this  i)owerful  machine  has  had  the 
effect  of  revolutionizing  radiography.  It  is  no  longer 
difficult  to  make  a  radiogram  of  any  part  of  the  body  in 
an  instant  of  time. 

There  are  three  types  of  apparatus  entirely  different  in 
the'ir  construction,  in  which  the  closed  circuit  type  of 
transformer  is  used, —  (1)  the  high  potential  rotary  recti- 
fier or  so-called  interrupterless,  (2)  the  Tesla,  and  (3) 
the  condenser  and  alternating  type,  called  the  McCaa 
transformer. 

The  high  potential  rotary  rectifier  and  interrupterless 
transformer  is  operated  by  an  alternating  current  gener- 
rated  from  a  motor-converter — a  rotary  transformer — with 
an  extension  of  the  shaft  of  the  motor-converter  operating 
a  high  potential  pole  changing  switch  (Fig.  26).  This 
switch  is  set  in  such  a  position  as  to  catch  the  peak  of  the 
alternating  wave  from  the  secondary,  in  such  a  manner 
as  to  bring  the  positive  impulses  to  one  discharge  post 
and  the  negative  impulses  to  the  other. 

In  this  manner  a  unidirectional  current  is  produced,  and 
all  inverses  are  avoided.  The  apparatus  is  particularly 
valuable  on  that  account  for  radiography  and  radio- 
therapy, and  adaptable  as  all  other  transformers  are  when 
used  in  connection  with  the  proper  resonator,  for  the  in- 
duction of  high  potential  therapeutic  currents,  thereby 
combining  in  one  apparatus  the  best  type  of  x-ray  appa- 
ratus with  an  apparatus  in  every  way  capable  for  the 


COMPARISON  OF  CURRENTS 


95 


induction  of  currents  of  high  frequency  and  high  peri- 
odicity. 

The  condenser  and  alternating  type  called  the  McCaa 
transformer  equipment,  consisU  of  an  alternator  driven 
by  a  small  m(>t4)r,  and  connected  in  s<^'ries  with  a  large 
condenser  primary  of  the  transformer  and  the  line  cur- 
rent (Fig  27).  Oscillations  are  thus  set  up  in  the 
primary   from   the  discharging  of  the  condenser,  which 


Laroc  C-C)r>d«int>e.r 


Fig.  27.    McCaa  Transformer. 
A,  Alternator;   I,    Inductamcc  Switch;  R,  Rheostat;  M,  Meter. 


cause  by  induction  the  high  potential  discharge  at  the 
secondary  terminals.  With  this  construction  either  an 
alternating  or  pulsiiting  high  potential  current  can  be 
generate  at  the  will  of  the  operator.  Tlie  number  of 
these  oscillations  can  be  varied  from  60  to  800  per  second, 
and  can  \ye  used  through  an  x-ray  tube  or  high  frequency 
resonator. 


96  HIGH-POTENTIAL  CURRENTS 

Mixed  types  of  high  p'equency  apparatus  have  been 
placed  upon  the  market  by  different  manufacturers,  which 
have  various  arrangements  for  administering  different  de- 
grees of  potential,  amperage  and  frequency  under  modi- 
fications produced  by  varying  the  condenser  capacity, 
spark-gap,  and  their  arrangement  with  solenoids  or  coils 
in  circuit  with  the  patient.  Most  of  these  devices  are 
made  for  use  ^Ith  the  alternating  current.  When  the 
direct  current  is  used,  a  rotary  transformer  is  provided 
in  the  circuit  for  changing  to  the  alternating  current. 
These  combination  coils  are  generally  so  constructed  as 
to  vary  the  current  from  the  sharp  stinging  discharges  of 
the  Tesla,  to  the  softer  heating  effects  as  of  the  d' Arson val 
current.  With  these  devices  it  is  possible  often  to  be  very 
much  misled  by  the  variations  pix)duced  in  readings  of 
the  hot  wire  meter  in  circuit ;  for  in  these  various  current 
conditions  that  are  produced,  the  hot  wire  meter  is  not  an 
accurate  guide  as  to  the  current  amperage,  because  in- 
creasing the  frequency  of  the  discharges  increases  the  read- 
ings without  increase  of  amperage.  The  test  as  stated  else- 
where, of  the  efficiency,  will  be  the  extent  to  which  the 
usual  seance  will  low^er  arterial  tension  in  cases  of  hyper- 
tension. For  the  induction  of  hyperemia  the  current 
strength  will  be  as  in  all  cases  regulated  to  the  toleration 
of  the  patient  and  the  indication  for  a  case  in  question. 

The  Tesla  apparatus^  so-called,  consists  of  a  compara- 
tively low  voltage  rotary  converter,  for  changing  the  cur- 
rent from  direct  to  alternating,  connected  in  series  with 
the  primary  of  an  oscillation  transformer  and  a  compara- 
tively low  capacity  condenser.  This  apparatus  delivers  a 
high  frequency  alternating  current  of  relatively  low 
amperage  and  must  be  used  in  connection  with  a  valve  tube 


COMPARISON  OF  CUKKENTS 


97 


98  HIGH-POTENTIAL  CURRENTS 

or  bifocal  x-ray  tube  for  producing  the  Roentgen  ray.  The 
aboye  described  construction  is  called  the  Tesla  coil.  The 
method  however,  in  which  Mr.  Tesla  constructed  his  equip- 
ment was  somewhat  different  in  that  much  higher  initial 
frequencies  could  be  taken  into  the  primary  of  the  trans- 
former and  he  also  used  a  transformer  which  delivered 
a  much  higher  voltage  than  the  apparatus  made  to-day, 
besides  building  the  oscillation  transformer  in  a  different 
way.     (Fig.  18.) 

Other  types  of  so-called  Tesla  coils  are  being  manufac- 
1  d  of  various  features  of  construction,  and  are  called 
Tesla  apparatus.  These  coils  step  up  the  voltage  and  pro- 
duce currents  alternating  in  character  which  while  not 
true  Tesla  currents,  are  capable  of  producing  some  of  the 
therapeutic  effects  of  the  high  potential  currents.  Fig. 
28  represents  the  arrangement  in  one  of  this  type  of 
apparatus. 

These  devices  are  not  adaptable  to  use  for  administer- 
ing auto-condensation  or  auto-conduction,  but  suffice  well 
to  meet  other  indications  for  high  frequency  treatment; 
viz. :  the  stimulating  effects  of  the  vacuum  tube  discharges 
and  effluvation  or  fulguration.  It  is  a  very  convenient 
portable  x-ray  outfit  combining  means  for  applying  the 
high  frequency  referred  to.  Manufacturers  in  general 
have  used  the  term  Tesla  current  for  nearly  every  type 
of  construction  from  the  resonator  excited  by  a  coil  to 
the  resonator  operated  by  a  static  machine;  but  this  is 
generally  erroneous;  in  that  the  resonator  ordinarily  used 
in  connection  with  the  various  coils  and  static  machines 
delivers  frequencies  of  moderate  rates  while  the  oscilla- 
tions from  the  small  Tesla  apparatus  which  is  made  up 
in  portable  and  semi-portable  form  delivers  frequencies 


C0MPAKI80N  OF  CURRENTS 


99 


approximately  fifty  times  as  great  per  sectmd,  whicli  con- 
sequently represents  a  very  different  type  of  current.    In 


tOO^OOOVolf^ 

1 .0 OQ o  o o  Osci I laTioYi^ 


i 


3o,oooVolt^ 


mmm- 


^6 


a»idCcxACh 

Flo.    29.      So-called    Tesla    Typos    for    Administering    Auto-Condensation 
and  Other  Treatment. 


fact  if  it  were  not  for  these  very  rapid  oscillations  in  the 
condenser,  the  effectiveness  of  the  so-called  Tesla  appa- 
ratus wonld  be  v<*rv  low. 


100  HIGH-POTENTIAL  CURRENTS 

The  particular  advantage  of  the  Tesla  over  the  other 
types  for  use,  is  in  cases  in  which  small  currents  are 
necessary  and  the  alternating  current  alone  at  the  dis- 
posal of  the  operator.  The  portability  of  the  apparatus 
also  renders  it  possible  to  employ  it  at  the  houses  of 
patients  in  which  either  of  the  commercial  currents  is 
furnished. 

There  has  recently  been  placed  upon  the  market  other 
new  types  of  transformer  apparatus  for  treatment  work 
only,  where  the  alternating  current  can  be  used  directly 
into  the  primary  without  the  interception  of  a  rectifier, 
interrupter,  or  synchronizer  (Fig.  29). 

This  apparatus  consists  of  a  closed  magnetic  circuit 
transformer  capable  of  delivering  a  two  to  three  inch 
discharge,  the  secondary  being  connected  to  Leyden  jars 
and  a  resonator  in  circuit  constructed  along  the  lines  of 
the  ordinary  Oudin.  The  d'Arsonval  current  is  taken 
from  the  end  of  the  spiral  and  the  point  which  taps  out 
the  different  turns,  precisely  as  is  done  when  the  coil  or 
static  machine  generates  the  initial  high  potential  current. 

Apparatus  for  use  tcith  the  alternating  current:  The 
alternating  current  is  so  rapidly  displacing  the  direct 
current  in  commercial  circuits,  that  new  problems  are 
constantly  arising  for  solution,  particularly  with  the  phy- 
sicians who  employ  to  far  greater  advantage  the  direct 
current  for  apparatus  operated  by  motors,  and  Ruhm- 
korflf  coils  and  wall  plates;  and  many  others  are  placed 
at  a  great  disadvantage  when  power  companies  change 
the  current  from  direct  to  alternating.  The  static  machine 
to  be  successfully  operated  requires  a  means  of  speed 
control  whereby  the  volume  of  current  flowing  into  the 
motor  can  be  regulated  for  which  purpose  the  direct  cur- 


COMPARISON  OF  CURRENTS 


101 


rent  resistance  ei>ntr(»ller  is  the  best  met  hod  for  speed 
control.  The  nnclianical  si>icd  controller  is  (he  best  sub- 
stitute Itut  not  so  well  adapted  for  the  employment  of 
hijih  speed  in  connection  with  the  production  (vf  the  static 
current. 

This  subject  has  also  handicapped,  in  many  instances, 
the  manufacturers  of  apparatus,  in  that  the  direct  current 
has  been  most  jicncrally  in  demand  Ity  the  profession,  and 


I'll,.   l^U.     Kheustat. 


that,  now  the  ai»|>aratus  nn(h'r  process  of  construction  are 
oftrn  of  tlie  direct  <-urrent  type. 

Variou.s  means  of  current  transformation  have  been 
devised  iov  th(»  purfH^se  »)f  rectifyinfj^  (►r  chanijing  the 
alternatinj;  into  the  direct  current,  including  ( 1 )  the  motor 
dynanu),  (2)  the  Cooper  Hewitt  rectifier  and  (^1)  the 
electrolytic  rectifier.  Any  device  that  can  succeed  in  this 
form  of  transformer  will  1m'  most  arcept4il)le  to  the  medi- 
cal profession  and  to  the  manufacturers  of  apparatus. 


102 


HIGH-POTENTIAL  CUKRENTS 


The  motor  dynamo,  though  expensive  is  the  most  prac- 
tical means  of  current  transformation.  It  consists  of  an 
alternating  current  motor  (Fig.  32),  which  actuates  a 
direct  current  dynamo,  and  is  constructed  in  the  most 


Fig.  31.     Inductive  Rheostat. 
A,  Iron  Core;  B,  Terminal  of  Winding. 

economical  type  upon  a  continuous  shaft.  A  physician's 
outfit  comprising  a  motor-dynamo  of  ten  to  fifteen  amperes 
capacity  or  less  for  smaller  plants,  is  capable  of  trans- 


FiG.  32.     Motor  Generator. 
A,  A.  C.  Motor;  B,  D.  C.  Generator. 

forming  a  current  for  use  with  the  direct  current,  Ruhm- 
korff  coil  Tvith  the  motors  used  for  operating  static  ma- 
chines and  vibrators  as  well  as  for  connection  with  the 
wall  plate.     This  is  undoubtedly  the  most  practical  type 


COMPARISON  OF  CURRENTS 


103 


uf  trausformer,  but  add.s  au  expeuso  of  fllOO  to  |000  to 
the  physician's  outfit,  whicli  is  to  be  considered  only  as 
an  element  of  first  cost,  as  the  ai)paratus  will  last  for 
an  indefinite  time  with  ordinary  pre<*autions  as  to  oiling 
and  care  in  not  makin<2;  exeessiv<'  demands  on  the  gener- 
ator.    The  apparatus  is  also  economical  in  principle  as 


Fig.  33.     Cooper  Hewitt  Rectifier. 


the  current  drawn  for  consumption  will  regulate  the  cur- 
rent taken  from  the  commercial  circuit  for  excitintr  the 
actuating  motor.  The  current  generated  and  power  con- 
sumed is  relative  to  the  demand — the  speed  and  actuating 
capacity  increasing  up  to  the  full  demand  (►f  the  direct 
current  generator  to  actuate  current. 


104  HIGH-POTENTIAL  CURKEXTS 

The  Cooper  Hewitt  rectifier^  Fig.  33,  is  probably  the 
next  best  means  of  transformation.  It  has  however,  the 
disadvantage  of  necessitating  a  continuous  flow  of  current 
through  the  bulb  whether  it  is  being  used  into  the  prim- 
ary of  a  transformer  or  not,  during  the  short  intervals 
in  which  the  operator  is  obliged  to  shut  off  his  current 
from  the  apparatus.  It  has  the  advantage  however,  of 
giving  a  continuous  flow  of  unidirectional  current  up  to 
its  full  capacity  and  is  very  satisfactory   for  charging 


Fig.  34.     Electrolytic  Eectifier. 
A,  Aluminum  Plate;   C,  Lead  or  Carbon  Plate. 

storage  batteries,  which  requires  a  direct  current;  for  in 
this  case  some  means  can  be  employed  to  shut  off  the 
current  when  the  apparatus  is  temporarily  disconnected. 
The  electrolytic  rectifier,  Fig.  34,  consists  of  aluminum 
and  lead  or  carbon  electrodes  immersed  in  a  saturated 
solution  of  bi-carbonate  of  soda,  sulphate  of  magnesium, 
sodium,  potassium,  or  ammonium  phosphate.  For  the 
best  results  four  cells  are  used  and  connected  in  such  a 
way  that  the  positive  current  can  be  taken  from  one  side 


COMPARISON  OF  CURRENTS  lo:. 

and  the  iic.i^alive  frimi  the  other  and  have  both  sideJi  of 
the  line  effective.  For  some  purposes  a  one-cell  rectifier 
is  used,  in  whii-li  ease  one  side  of  the  line  is  suppressed, 
while  the  other  delivers  a  unidirectional  current  up  to  forty 
or  tifty  volts,  but  is  not  suitaltle  for  oi)oratin.i;  motors 
or  galvanic  or  Faradic  switchboards  or  under  conditions 
when  a  contiinunis  cun-cnt  is  necessary.  The  action  of 
this  instrument  or  apparatus  depends  upon  the  rajiid  for- 
mation of  an  aluminum  compmind  on  the  aluminum  plate 
when  the  current  is  passinji;  from  the  ir()n  or  carbon 
toward  the  aluminum,  the  compound  offerinfj  a  very  high 
resistance  and  for  the  time  checking  the  current  from 
making  a  complete  circuit.  At  the  interval  when  the  cur- 
rent is  j)assing  from  the  aluminum  to  the  carb(»n  this  film 
of  aluminum  compound  no  longer  retains  its  insulating 
quality  and  allows  the  current  to  pass.  It  can  be  readily 
seen  that  the  combination  of  four  of  these  can  be  so  con- 
nected that  each  cycle  fi*om  the  line  can  be  taken  advan- 
tage of.  The  most  desirable  compound  to  use  due  to  its 
cheapness  especially,  is  bi-carbonate  of  soda  in  the  pro- 
portion of  one  part  of  bi-carbonate  of  soda  to  twelve  parts 
of  water.  l)oth  by  measure.  It  has  also  the  important 
advantage  of  not  crystalizing  and  in  forming  insoluble 
compounds  which  partially  reduce  the  capacity  of  the 
outfit  by  clinging  to  the  metallic  parts. 

The  liifjh  frequency  resonator.  The  apparatus  com- 
mercially known  as  the  high  frecpiency  resonator  can  be 
operate<I  from  the  Ruhmkorff  coil,  the  high  potential 
rotary  rectifier  (so-called  interrupterless  apparatus),  the 
McCaa  transformer  e<|uipment  or  the  static  machine  and 
is  constructed  <ui  practically  the  same  plan  for  all  these 
types  of  apparatus.    The  length  and  size  of  the  d'Arsonval 


106 


HIGH-POTENTIAL  CURRENTS 


solenoid  for  the  Rhumkorff  and  other  types  of  transformer 
require  from  six  to  fifteen  turns  from  eight  to  twelve  inches 
in  diameter  of  coarse  wire,  while  the  d'Arsonval  solenoid 
for  the  static  machine  should  be  of  coarse  wire  having  from 
thirty-five  to  forty  turns  in  the  solenoid  wound  from  four  to 
six  inches  in  diameter.     Another  part  which  necessitates 


Fig.  35.     Types  of  Condensers:   Leyden  Jar  and  Glass  Plate. 
Leyden  Jar:  A,  Conductor  for  Inner  Armature  or  Layer  of  Foil;  B,  Con- 
nection   for    Outer    Armature;    C,    Dielectric;    D,    Tinfoil    or    Copper 
Plate;   E,   Band  Around  Jar  for  Outer  Connection.     Glass  Plate:   A, 
Terminal;  T>,  Dielectric;   T,  Plates  of  Tinfoil  or  Select  Metal. 


variations,  is  the  capacity  of  tlie  condensers,  which  is  a 
very  simple  matter.  The  condenser  capacity  in  the  type 
of  static  resonator  constructed  to  produce  the  pulsatory 
Oudin  or  Tesla  discharges  should  be  of  approximately 
three  times  the  capacity  as  measured  by  the  extent  of  the 
surface  coating  of  metal  on  the  outer  and  inner  surfaces 


COMPAIUSON  OF  CURUENTS 


107 


108  HIGH-POTENTIAL  CURRENTS 

of  the  Lejden  jars  or  glass  plate  type  of  condensers  used 
in  connection  with  the  same  apparatus  for  inducing 
d'Arsonval  current  as  employed  for  the  auto-condensation 
or  auto-conduction. 

The  essential  parts  of  a  resonator  consist  of  a  solenoid, 
condenser,  and  the  spark-gap  over  which  may  be  placed  a 
second  solenoid  and  insulated  for  the  induction  of  the  Tesla 
current  and  an  additional  solenoid  for  connection  with 
the  Tesla  or  d'Arsonval  for  stepping  up  to  the  Oudin 
current.  (See  Figs.  16  and  18.)  Although  there  are  two 
ways  of  winding  a  solenoid,  it  really  consists  of  numerous 
turns  of  wire,  as  previously  described,  the  turns  separated 
by  at  least  %  inch,  one  end  terminating  in  a  binding  post 
from  which  is  taken  the  Oudin  current,  Fig.  19.  The  other 
end  of  the  resonator  is  attached  to  the  outer  coating  of 
the  condenser  while  the  outer  coating  of  the  other  con- 
denser terminates  in  a  clamp,  which  makes  it  possible  to 
tap  out  any  number  of  turns  desirable  for  varying  the 
d'Arsonval  circuit.  The  inner  coatings  of  the  jars  are  in 
direct  metallic  connection  with  the  coil  or  static  machine 
while  at  some  convenient  point  in  the  circuit  is  placed 
the  spark-gap  or  discharger,  which  has  the  effect  of 
charging  and  discharging  the  Leyden  jars  when  the  ap- 
paratus is  in  action.  When  it  is  required  to  operate  the 
apparatus  the  variable  tap  connection  is  attached  to  one 
of  the  turns  of  the  solenoid  which  will  produce  the  best 
resonance  and  effleuve  at  the  Oudin  end  of  the  solenoid. 
When  however  it  is  desired  to  use  the  d'Arsonval  current 
connection  is  made  from  one  end  of  the  solenoid  to  the 
metal  strip  under  the  cushion  of  the  auto-condensation 
pad  and  the  other  is  brought  out  from  the  point  which 
governs  the  number  of  turns.     This  is  connected  to  the 


COMPAKISON  OF  CURRENTS 


10!) 


110 


HIGH-POTENTIAL  CURRENTS 


bifurcated  cords  with  the  electrodes  to  be  held  in  the 
hands  of  the  patient  at  the  two  extremities.  There  have 
been  several  deviations  from  this  construction,  but  the 
above  describes  the  resonator  in  its  most  simple  and  satis- 
factory form. 


Fig.  38.     The  Step-up  Solenoid. 
A,  Selective  Eheostat;   B,  Winding  of  Eesonator. 


An  important  feature  in  the  construction  of  a  resonator 
is  the  size  of  the  box  or  detonating  chamber  in  which  the 
spark  discharges.  The  tendency  for  moisture  to  constantly 
accumulate  in  this  chamber  often  interferes  with  the  pro- 
duction of  the  required  milliamperage  by  the  occurrence 


COMPARISON  OF  CURRENTS  111 

of  short  circuits  due  to  dampness  in  the  walls  of  the 
niuttler  or  detonating  chamber.  It  should  have  therefore, 
at  least  a  capacity  of  1,500  cubic  inches  with  a  door  on 
one  side  which  can  be  opened,  for  ventilation  when  not 
in  use,  and  may  be  provide<i  with  some  drying  material 
for  absorbing  the  moisture.  This  is  one  of  the  most 
important  featui-es  to  be  considered  in  tiie  construction 
of  a  resonator. 


CHAPTER  III 


d'aesonvalization 


The  current  of  d'Arsonval  which  is  destined  to  play 
such  an  important  role  in  therapeutics,  was  first  pub- 
lished by  Prof.  d'Arsonval  in  the  year  1893,  Subsequently 
he  developed  methods  of  employing  the  current  in  con- 
nection with  couches  and  solenoids  under  the  terms  auto- 
condensation  and  auto-conduction.  These  methods  have 
been  materially  varied  since  their  introduction  by  d'Arson- 
val; but  the  principles  of  action  and  their  effects  were 
well  studied  by  him.  The  profession  however  have  been 
slow  in  appreciating  the  significance  of  these  modalities 
and  adopting  them  in  the  treatment  of  numerous  condi- 
tions for  which  they  are  so  remarkably  adapted;  notably 
in  conditions  of  high  arterial  tension,  mal-nutrition  and 
malassimilation,  and  more  recently  the  employment  of  the 
direct-method  for  its  thermic  effects  for  the  induction  of 
hyperemia  and  other  effects.  These  have  placed  humanity 
under  a  lasting  obligation  to  the  great  physiologist. 

The  method  known  as  auto-condensation  (see  Fig.  17), 
would  seem  in  its  designation  to  be  a  misnomer;  for  the 
current  is  passed  in  and  out  of  the  patient  who  becomes 
passively,  not  actively,  a  condenser.  If  the  term  body 
condensation  or  patient  condensation  were  to  be  em- 
ployed, it  would  better  explain  the  conditions.  The  term 
thermic  condensation  has  been  suggested,  because  of  the 
heat  produced  by  this  method.    This  title  also  has  the  dis- 

112 


COMPAKISON  OF  CURRENTS 


113 


advantage  of  not  being  distinctive,  heat  being  induced  in 
numerous  other  ways. 

The  devices  used  in  connection  with  auto-condensation 
treatment  to  be  considered  aiv  the  couch,  the  condenser, 
the  cushion  and  the  electrodes. 

It  matters  little  what  is  used  for  the  auto-condensation 
couch.  It  may  often  he  thought  that  the  couch  should 
be  of  a  non-conducting  material,  which  is  not  necessary, 


Fig.  39.     Bowen  Static  Chair  Designed  by  Author. 


ijecause  the  two  oi)posite  ciiarges  of  the  (l'Ar.st)nval  cur- 
rent are  certain  to  occupy  tields  of  condensation  as  near 
as  possible  to  each  other.  Two  styles  of  couches  shown 
in  Figs.  39  and  40,  are  excellent  for  use  with  this  method 
of  treatment,  because  the  patient  rests  relax<Hl  in  a  com- 
fortable attitude  with  tiie  limbs  extrn<lcd,  which  is  de- 
sirable. A  table  or  ordinary  lounge  in  lieu  of  a  chair 
will  answer  every  purpose  of  efficiency  for  the  administra- 
tion of  auto-conden.sation  treatment. 


114 


HIGH-POTENTIAL  CURRENTS 


The  cushion  should  be  approximately  three  inches  in 
thickness,  six  feet  long  and  twenty  inches  wide  and  may 
be  made  of  any  non-conducting  material,  cotton,  felt,  or 
silk  waste,  ans^'ering  the  purpose  equally  w^ell.  The 
cushion  should  be  firmly  tied  and  of  a  material  that  will 
not  too  readily  pack  together,  because  wherever  the 
cushion  is  thinnest,  most  of  the  current  must  accumulate. 


Fig.   40.     Austrian  Bentwood   Chair. 


The  covering  of  the  cushion  may  be  of  denim,  silk  or 
leather  or  other  non-conducting  material.  Patent  leather 
imitations,  which  contain  mineral  paints,  are  objectioni- 
able  as  they  are  too  good  conductors  of  the  current. 

The  metal  condenser  which  may  be  made  of  wire  mesh 
or  metal  plates  jointed  or  otherwise,  should  be  of  a  size 
that  will  lay  about  three  inches  within  the  margin  of  the 
cushion  on  all  sides.    A  very  convenient  w^ay  of  arranging 


COMPARISON  OF  CURRENTS  115 

the  condenser  sheet,  is  to  place  a  wire  mesh,  not  too  fine 
or  too  coarse  on  the  under  side  of  the  felt  l^neath  a 
layer  of  fiber.  If  this  is  done,  a  chain  which  should 
pass  out  at  one  corner  of  the  cushion,  must  be  well  soldered 
to  the  metal  condenser  as  if  there  is  for  any  reason  spark- 
ing, as  there  is  certain  to  he  if  the  connections  are  loose, 
it  would  ignite  the  cushion.  The  advantage  of  the  wire 
mesh  is  that  the  cushion  and  condenser  combination  is 
flexible  and  fits  the  different  styles  of  chairs  with  the 
backs  in  different  positions.  The  advantage  of  having 
the  condenser  beneath  the  cushion  extend  nearly  the  full 
length  of  the  cushion  is  apparent  for  purposes  of  current 
condensation  the  intent  being  to  bring  as  much  of  the 
body  of  the  patient  as  possible  into  the  field  of  opposite 
electrical  condensation. 

The  electrodes  to  be  held  in  the  hands  of  the  patient 
may  be  either  two  electrodes  attached  to  a  bifurcated  cord 
which  is  connected  to  one  side  of  the  d'Arsonval  solenoid, 
or  a  single  cord  connecting  a  single  electrode  long  enough 
to  place  the  two  hands  upon  it.  Arrangements  are  also 
made  by  which  the  electrodes  are  fastened  to  the  chair, 
the  patient  upon  the  couch  placing  the  hands  upon  the 
electrodes.  Any  of  these  devices  are  practical.  It  is  only 
to  be  borne  in  mind  that  the  patient  should  hold  both 
hands  upon  the  electroile  or  eliH^trcxles  so  that  the  current 
will  pa.^s  unifoi-nily  to  the  two  sides  of  hi.'^  ])ody. 

A  hot  icire  meter,  Fig.  40,  is  another  indispensable  fac- 
tor to  l>e  used  in  connection  with  d'Arsonvalizat  ion.  While 
these  meters  may  not  be  entirely  reliable  and  do  not  com- 
pare with  a  definite  standard,  if  differences  are  not  too 
great,  they  serve  for  general  purposes  as  a  practical  means 
of  measuring  the  relative  heat  production  of  the  current 


116  HIGH-POTENTIAL  CURRENTS 

employed.  An  accurate  standard  should  be  adopted  based 
upon  a  relative  heat  production  by  the  constant  cui'rent. 
In  these  instruments  the  heating  effect  of  the  electric 
current  in  a  wire  of  suitable  resistance  is  by  a  special 
mechanism  made  to  serve  the  purpose  of  indicating  the 
current  or  potential  in  the  measjuring  apparatus.  The 
quantity  of  heat  developed  by  the  unit  of  current  in  the 
unit  of  time  is  the  same  for  any  kind  of  current,  direct  or 


Fig.  41.     Hot  Wire  Meter. 

alternating  (of  any  periodicity)  and  is  quite  independent 
of  the  phase  or  method  of  generation.  The  instruments 
should  be  made  without  magnetic  fields  or  solenoids,  in 
order  that  they  will  be  entirely  free  from  self-induction. 
The  measuring  or  hot-wire  is  of  platinum  silver  which  is 
stretched  between  the  two  terminals;  in  the  centre  of 
this  wire  another  wire  of  phosphor  bronze  is  attached 
at  right  angles  and  held  taut  by  a  third  terminal;  near 


COMPAKISON  OF  CURRENTS  117 

the  conti-e  of  tlu'  phasphor  bronze  wii-f,  a  cotton  tibre 
is  tixtnl  on  one  end  at  ri.ulil  anj^los,  at  the  other  end 
passing  iH)und  a  special  grooveil  metal  a  roller  is  lixed 
on  a  pivote<l  steel  spindle,  nionntinl  in  jewels  and 
finally  terminating  in  a  small  eyelet  attaehmeiit  to  a  Hat 
steel  spring.  The  whole  arrangement  of  the  fibre  wire 
is  thus  subjected  to  tension  and  ajiy  slackening  or  "  sag" 
of  the  measiiring  wire  is  immediately  taken  up  by  the  steel 
spring  and  is  transmitted  by  the  phos])lK)r  bronze  wire  and 
tibre  to  the  grooved  roller  which  can-ies  the  ix)inter.  By 
this  method  the  smallest  extension  of  the  wire  is  greatly 
magnified  and  conveyed  to  the  pointer,  thus  rendering 
the  deflections  easily  perceptible.  The  means  provided  to 
reset  the  pointer  to  the  zero  position  in  case  of  need  con- 
sist of  a  very  fine  pitched  screw  passing  through  one  of 
the  supports  of  the  measuring  wire.  This  screw  wiiich  is 
iwljustable  from  a  hole  in  the  case,  moves  very  slightly 
an  ai'm  of  the  measuring  block  to  which  the  wire  is 
attached. 

Auto-conduction  possesses  the  same  error  as  to  signifi- 
cance of  terminology  as  auto-condensation,  the  patient 
being  the  conductor  of  the  current  passively  not  actively, 
but  acted  upon  by  the  current  in  its  passage.  lUuli/- 
conduction  and  hody-condcnsution  would  bettor  convey  the 
idea  of  these  modalities,  and  cause  less  obscurity  in  the 
minds  of  students  as  they  would  convey  correct  impressions 
as  to  the  methcnl  in  which  the  physiological  effects  are 
produced. 

I'hc  method  of  bodi/-candensatio)i  <»r  duto-condcnsatitni 
is  appli<Hl  by  the  arrangement  shown  in  Fig.  17.  The 
patient  is  seated  uiM>n  the  auto-condensation  couch,  insu- 
lateil  by  the  cushi(>n  fi-oin  a  ni«*tal  she^'t  plac<'d  beneath, 


118  HIGH-POTENTIAL  CURRENTS 

which  is  connected  to  one  side  of  the  d'Arsonval  circuit, 
the  other  side  of  which  is  connected  to  the  patient  usually 
by  two  electrodes  to  be  held  in  the  hands,  which  are  con- 
nected by  a  bifurcated  cord.  When  employed  in  this 
manner  the  patient's  body  is  successively  charged  and 
discharged  by  the  oscillatory  or  pulsatory  discharges 
passing  through  the  resonator.     (See  Frontispiece.) 

The  current  in  its  passage  under  existing  conditions  has 
a  tendency  to  accumulate  with  greater  condensation  to  the 
surfaces  or  parts  of  the  body  nearest  the  condenser  beneath 
the  cushion.  The  d'Arsonval  current  however,  is  one  of 
so  low  potential,  that  the  charge  in  passing  against  the 
resistance  of  the  body  tissues  seems  to  be  largely  diffused. 
Whether  this  warmth  is  due  to  an  action  upon  the  heat 
centers,  or  direct  action  of  the  current  upon  the  tissues, 
or  to  the  general  diffusion  of  heat  from  the  parts  of  the 
body  which  have  become  heated  in  the  path  of  the  current, 
during  the  administration,  is  a  subject  for  consideration. 
If  any  part  of  the  body  is  subjected  to  current  condensa- 
tion with  the  consequent  hea.t  production,  the  effort  to 
maintain  a  body  equilibrium  of  temperature  quickens  the 
general  circulation,  with  the  dissipation  of  the  heated 
blood  to  all  parts  of  the  economy,  as  evidenced  by  a  con- 
sequent glow  of  warmth  at  the  surface.  The  tendency 
as  indicated  is  greater  under  the  relatively  low  potential 
of  the  d'Arsonval  current  for  it  to  diffuse  to  considerable 
extent  throughout  the  tissues  and  indicates  that  the  effect 
may  be  largely  due  to  the  passage  of  the  current  through 
the  tissues.  The  effects  of  the  current  upon  general 
metabolism  and  blood  pressure  are  very  marked;  and 
likewise  indicate  an  effect  which  may  be  due  to  the  general 
diffusion  of  the  current. 


COMPARISON  OF  (^IRKENTS 


119 


Auto-vonduvtioii  is  administered  with  the  patient  lying 
or  standing  within  a  large  solenoid.  The  passage  of  lines 
of  electrical  energy  between  the  opposite  sides  of  the 
solenoid,  creates  numerous  currents  in  every  direction 
throughout  the  body  of  the  patient  which  becomes  a  con- 
ductor between  the  opposite  sides  of  tiie  solenoid.  It  is 
easily  demonstrated  physically,  that  a  piece  of  metal 
placed  within  a  small  solenoid  through  which  a  current  of 


i^imiininni. 


mimium 


Fig.  42.     Arrangement  for  Employing  Direct  tl'Arsonvalization. 


fairly  large  ami)erage  and  high  frequency  is  pa.ssing,  will 
be  heated  to  a  red  or  white  heat.  This  is  the  principle  of 
action,  under  regulation  when  a  patient  within  a  large 
solenoid  experiences  the  thermic  efifect  <»f  the  current 
generally  throughout  his  person.  While  clinically 
demonstrated  to  be  inferior  to  auto-condensation,  it  is 
evident  that  general  etfeet^s  must  be  produced  throughout 
the  economy  by  its  unifonn  passage.  The  heat  accumu- 
lated within  the  body  under  tht^se  conditions  is  quite 
uniform,    but    the    effects    upon    blood    pressure    while 


120  HIGH-POTENTIAL  CURKENTS 

marked  are  not  so  reliable  as  auto-condensation.  It  is 
difficult  however  to  determine  as  in  auto-condensation  just 
how  this  procedure  affects  blood  pressure,  for  the  modus 
operandi  can  not  be  readily  demonstrated.  AVith  both 
methods  the  thermic  effects  are  so  manifest  that  there  is 
strong  evidence  that  it  may  be  due  to  thermic  action. 

Another  method  of  employing  the  d'Arsonval  current 
may  be  designated  the  direct  method  of  d' Arsonvalization 
The  arrangement  (Fig.  42)  consists  in  placing  two  elec- 
trodes upon  surfaces  removed  from  each  other ;  such  elec- 
trodes being  connected  by  rheophores  to  the  two  sides  of 
the  d'Arsonval  circuit.  This  method  may  be  employed 
either  with  two  metal  or  two  glass  vacuum  electrodes  or 
one  of  each  for  the  purpose  of  meeting  various  indications. 
The  object  of  this  method  is  chiefly  for  its  thermic  effects 
upon  the  tissues;  induced  for  the  purpose  of  producing 
hyperemia.  It  has  been  demonstrated  that  by  this  method 
a  current  of  sufficient  milliamperage,  as  measured  by 
the  hot  wire  meter,  may  be  passed  through  a  piece  of  liver 
or  other  meat,  to  actually  cook  it.  Under  these  condi- 
tions, the  greatest  thermic  effect  is  near  the  center  between 
the  opposite  electrodes  employed. 


CHAPTER  IV 

THE  TESLA   AND  OUDLN  CURRENTS 

The  Teshi  currvnt  as  produced  hy  the  originator,  con- 
sisted of  the  arrangement  of  a  primary  coil  the  same  as 
for  the  d'Arsonval  current;  and  tlie  swondary  coil  was 
placed  around  the  primary  and  insulatcnl  from  it  within  a 
vessel  of  oil.  (See  Fig.  16.)  By  this  arrangement  a  step 
up  current  of  high  potential  is  produced,  the  tension  of 
the  current  depending  upon  the  amperage,  length  of  wire, 
and  numl)er  of  windings  in  the  primary,  and  the  number 
of  the  same  in  the  secondary.  For  therapeutic  purposes, 
this  current  possesses  very  much  the  same  qualities  as  the 
Oudin  current,  particularly  so  when  the  source  is  fix)m  a 
static  machine,  and  one  terminal  of  the  Tesla  is  groundcnl. 
This  current  may  be  of  very  high  potential  an<l  freciucncy. 
The  potential  in  Tesla  apparatus  is  of  higher  potential 
than  the  d'Arsonval  current.  The  therapeutic  effects  are 
very  imich  the  same  as  of  those  of  the  Oudin  and  d'Arson- 
val currents  for  the  induction  of  superficial  hyiHTcmia,  and 
wiien  administereil  from  a  static  nuichiue  with  large  con- 
densers, the  discharges,  synchronous  with  the  spark  dis- 
charge within  the  resonator  are  capable  of  producing 
considerable  contraction  in  the  tissues — effei-ts  very  simi- 
lar ti*  those  of  the  static  brusli  discliarge.  The  Tesla  cur- 
rent is  the  least  used  of  the  high  fre<iuency  discharges 
except  as  a  step  up  between  the  d'Arsonval  and  the  Oudin 
currents.  Wlien  it  is  desin^l  as  in  some  tyjtes  of  resona- 
tors, particularly  those  employed  with  the  static  machine, 

121 


122 


HIGH-POTENTIAL  CURRENTS 


Fig.  43.     DeKraft's  High  Frequency  Resonator. 
Ai,  Aj,  Large  Leyden  Jar  Condensers ;     Ti,  Tn,  Tesla  Terminals ;     Li,    Ln, 
Line  Terminals  to  Source  of  Supply;     Di,  Dn,,  d'Arsonval  Terminals; 
S.  G.,  Spark  Gap;   M,  Mica  Tube. 

to  produce  a  maximum  potential,  the  Oudin  solenoid  is 
connected  to  one  side  of  the  Tesla  instead  of  the  d'Arson- 
val as  shown  in  Fig.  43. 

The  so  styled  Tesla  current  produced  with  various  styles 
of  apparatus  of  the  portable  type,  and  so-called  Tesla 


COMPARISON  OF  CURRENTS  123 

coils,  Fig.  2(1,  have  in  many  respocts  the  characteristics 
of  the  true  Tesla  current.  The  discharges  from  these  coils 
under  regulation  may  be  li(>t  or  mild  with  a  regulated 
potential  of  delivery  depending  upon  the  length  of  the 
spark-ga])  permitted  in  the  circuit.  The  field  for  this  type 
of  p()rtable  apparatus  which  are  manufactureil  also  for 
use  with  specially  designed  x-ray  tubes  for  radiographic 
and  therapeutic  purposes,  and  in  addition  for  the  induction 
of  local  hyperemia,  is  the  stimulation  of  local  metabol- 
ism, and  for  the  relief  of  mild  types  of  congestion.  They 
are  also  employed  for  the  application  of  the  efliuvation 
method  of  destroying  neoplasms  for  which  purpose  they 
are  well  adapted.  It  has  also  been  stated  that  these  ap- 
paratus are  adapted  for  the  auto-condensation  method, 
which  is  an  error,  for  the  d'Arsonval  current  of  lower 
potential  and  greater  amperage  cannot  be  duplicated  by 
the  portable  type  of  apparatus.  They  may,  however,  to 
a  degree  lower  high  blood  pressure,  but  do  not  produce 
the  characteristic  etfects  of  the  d'Arsonval  current. 

The  Oudin  current.  The  Oudin  current,  Fig.  19,  de- 
signed by  Professor  Oudin,  is  a  one  pole  modality;  that 
is,  the  administrations  are  made  from  the  extreme  term- 
inal of  a  solenoid  the  other  end  of  which  is  connected 
either  with  a  Tesla  or  d'Arsonval  solenoid.  The  imped- 
ance and  inductance  of  the  numerous  insulated  windings 
of  this  solenoid,  step  up  the  current  to  a  potential  de- 
pending upon  the  source  and  number  of  windings  which 
may  be  very  great. 

This  current  administered  as  steppetl  up  from  the  Tesla 
of  a  static  resonator,  is  very  much  accentuated  or  intensi- 
fied if  the  other  Tesla  terminal  is  grounded.  Under  these 
conditions  the  current  is  to  a  very  large  degree  pulsatory 


124  HIGH-POTENTIAL  CURRENTS 

or  polar  in  effect.  The  method  of  Dr.  Frederick  deKraft 
of  New  York  for  administering  this  current  is  one  of  the 
important  methods  of  employing  this  modality;  applying 
it  from  a  static  resonator. 

The  arrangement  employed  hy  Dr.  deKraft  with  the 
Oudin  currents  is  valuable.  When  it  is  desired  to  pro- 
duce the  most  profound  effect  constitutionally  upon  the 
patient,  the  application  is  made  as  connected  in  Fig.  43. 
An  electrode,  either  a  ring  or  a  multiple  point  device,  is 
placed  in  a  tube  holder  or  held  in  the  hands  of  the 
operator,  at  a  distance  at  which  the  pulsating  effleuves 
will  be  perceptibly  discharged  against  the  patient.  In 
order  to  intensify  the  effect  a  grounded  metallic  electrode 
may  be  placed  upon  the  back  or  opposite  side  of  the 
patient.  By  this  arrangement  it  is  possible  to  produce 
successive  fibrillary  and  mass  contractions  of  the  muscular 
structures  of  the  body,  which  remarkably  stimulate  meta- 
bolism and  to  a  degree  effect  the  resolution  of  local  stasis. 
By  varying  the  size  of  the  electrodes  and  output  of  the 
machine,  it  is  possible  to  localize  this  modality  to  any 
part  of  the  body  as,  for  the  treatment  of  ulcerated  surfaces 
with  small  ball  or  multiple  point  electrodes.  The  object 
of  this  form  of  treatment  is  two  fold :  ( 1 )  for  the  induc- 
tion of  local  hyperemia  in  which  it  is  peculiarly  energetic ; 
and  (2)  for  the  induction  of  active  local  or  general  meta- 
bolism. It  is  possible  also  by  this  method  to  lower  high 
arterial  tension. 

Fulguration  is  another  method  which  employs  the  Oudin 
current  from  various  sources.  The  same  method  may  also 
be  employed  with  the  Tesla  or  d'Arsonval  current,  the 
higher  potential  of  the  Oudin  not  being  requisite  for  the 
application  of  fulguration. 


SECTION  III. 

PHYSIOLOGICAL  ACTIONS 

AND  THERAPEUTICS  OF  HIGH 

POTENTIAL  CURRENTS. 


SECTION  III 

THERAPEUTICS  OF  HIGH  POTENTIAL 
CURRENTS 

CHAPTER  I 

TlIK    THYSICAL   EFFECTS   OF   THE    IIICII-l'OTENTIAL  CUUKENTS 

The  physical  effects  of  electrical  discharges  as  applied 
in  therapeutics  depend  largely  upon  their  capacity  to 
penetrate  the  body  and  the  nature  of  their  behavior  when 
brought  in  relation  to  normal  tissue  under  varying  con- 
ditions; such  effects  depending  u])on  the  varying  charac- 
teristics of  both  the  currents  and  the  tissues  in  accordance 
with  physical  laws.  The  study  of  these  actions  is  fraught 
with  less  difficulty  than  the  study  of  the  actions  of  medic- 
inal agents  emi)loyed  in  therapeutics,  because  definite 
physical  laws  govern  the  activity,  diffusion,  and  effects 
produced.  The  action  of  currents  and  other  discharges 
upon  animal  tissue  is  generally  demonstrable,  certain, 
and  reliable.  Once  proved  that  tissue  contracts  under  an 
electrical  stimulus,  either  by  action  upon  the  cell  or  the 
muscular  mass,  the  same  effect  will,  under  normal  condi- 
tions, be  constant  wherever  muscular  structures  are 
found,  deep-seated  or  superficial.  We  are  thus  enabled 
to  determine  with  certainty  the  action  of  these  currents 
upon  the  deejier-seated  structures  when  we  have  learned 
by  experience  to  employ  the  requisite  potential,  ami^er- 
age,  and  frequency  to  affect  them.  So  also  is  superficial 
cellular  activity, — general  or  local  metabolism, — is  me- 
chanically increased,  the  rule  will  be  established  that 
organs  elsewhere,  composed  of  the  same  tissue  elements 


126  HIGH-POTENTIAL  CURRENTS 

under  like  conditions,  will  respond  in  the  same  manner 
when  submitted  to  the  same  action.  It  is  only  necessary, 
then,  to  demonstrate  definite  effects  when  they  become 
established  laws,  and  we  are  enabled  to  anticipate  and 
account  for  results  with  comparative  accuracy.  The  ap- 
plication of  electricity,  when  its  laws  of  action  and  control 
are  discovered,  together  with  the  relative  effects  of  po- 
tential quantity  and  rate  of  discharge,  becomes  one  of 
the  most  rational  and  reliable  therapeutic  procedures. 

The  physical  effects  of  electricity  upon  animal  tissue 
must  depend  relatively  upon  the  characteristics  of  the 
modalities  employed.  The  ratio  of  quantity  (amperage) 
and  potential  (voltage)  of  the  current  determines,  if  high 
frequency  does  not  render  the  action  superficial,  whether 
its  action  will  be  destructive  (cauterant),  electrolytic  to  a 
large  extent,  or  act  as  a  simple  stimulant  or  vis-a-tergo, 
inducing  increased  functional  activity. 

The  nerves,  either  sympathetic  or  cerebrospinal,  can- 
not be  considered  as  electrical  conductors  conveying  cur- 
rents to  their  points  of  distribution.  They  are  affected, 
on  the  other  hand,  as  by  a  stimulant  which  excites  the 
neuron  and  its  axis  cylinder  to  its  characteristic  action. 
There  has  been  no  demonstration,  though  often  so  in- 
ferred, which  will  justify  the  position  that  the  nervous 
system  acts  in  any  way  in  conjunction  with  electricity  as 
conductors  per  se.  On  the  contrary,  the  arrangement  of 
the  nervous  system  is  not  such  as  will  warrant  such  an  hy- 
pothesis, ending  as  it  does  in  terminal  neurons  without 
circuits.  The  centripetal  and  centrifugal  impulses  cannot 
by  inference  or  demonstration  be  shown  to  bear  anv  rela- 


'THE  PHYSICAL  EFFECTS  I27r 

tion  to  electrical  circuits;  ou  the  contrary,  it  has  Ijcen 
demonstrated  that  nervous  tissue  is  not  the  best  conductor 
of  electrical  currents,  but  the  tissues  containing  the 
largest  vasculai^  supply,  «*fi. the  blood  vessels  aud  muscles. 
Furthermore,  nervous  impulses  are  relatively  yery  slow 
in  passage  as  comi)ared  with  the  velocity  of  electric  cur- 
rents. It  is  of  great  importance  in  the  colisi<leration  of 
the  i)hysical  actions  of  electricity  that  we  should  recogniKe 
the  behavior  of  the  various  electrical  phenomena  Under 
different  conditions,  in  order  that  we  may  accurately 
determine  its  destination,  physical  action,  and  })liysio- 
logical  effects.  ».i;  ^z:  lm,  i  •  ;..  .  ^;qi; .  .-;,>  -jjn  ii;!;iijT,,,. 
Currents  of  different  potentials  perform  differently  in' 
their,  passage  through  the  tissues.  Static  currents  of 
high  potential  are  universally  cliff  used  through  the  body 
when  administered  to  a  patient  insulated. and  jHajQedin, 
direct  connection  from  one  side  of  the  source  of  energy 
through  an  electrode  bv  ofther  connection  coming  in  con- 
tuct  with  an  electrode  placed  somewhere  upon  the  surface: 
of  the  body,  in  accord  with  the  law  that  snch  currents  seek 
to  immediately  surround  instead  of  occupy  a  ronducting 
medium  in  a  state  of  charge.  They  pass  to  fehetsurface 
by  the  tracks  of  relatively  least  resistance  and  in  irmrlif 
straight  lines  through  substances  having  but  slight  varia- 
tioB  in  resistance;  as  do  the  relatively  homogeneous  tis- 
sues of  the  human  body.  Currents  oi  Unr  pot(^n(inl,  on 
the  other  hand,  dn  n-ot  seem  io  enter. the  tissues  at  all 
when  connected  with  bnt  one  pole  of  a  source  of  electrical 
eberg\'.  When  sudi  currents  as  those  deri\'ed  from  the 
continuous-current  battery  pass  between-  the  two  poles,' 


128  HIGH-POTENTIAL  CURRENTS 

the  current  is  diffused  into  the  tissues  laterally,  as  a  slug- 
gish stream  coursing  through  a  flat  low  land. 

Tivo  essential  properties  of  all  electrical  currents  af- 
fecting their  action  are  the  voltage  (E.  M.  F.)  or  potential 
and  amperage  (quantity). 

Currents  of  great  potential  and  large  quantity  cauterize 
the  tissues  and  destroy  life  by  shock,  overwhelming  the 
cardiac  or  respiratory  centers  or  by  processes  of  dis- 
association  of  normal  arrangements  or  conversion  into 
other  combinations. 

Currents  of  very  large  amperage  and  relatively  low 
potential  are  also  capable  of  producing  the  same  effects. 
These  effects  are  also  produced  by  currents  of  relatively 
small  though  not  infinitesimal  amperage,  but  having  ex- 
tremely great  voltage  or  potential.  When,  however,  the 
amperage  of  a  current  is  so  small  as  1-5000  to  1-2000 
of  an  ampere,  the  voltage  or  potential  may  be  in  millions 
and  produce  no  dangerous  effect.  The  latter  are  the  cur- 
rents of  high  potential  without  reference  to  frequency 
which  are  of  great  value  therapeutically  because  they  are 
capable  of  great  diffusion  mechanically,  inducing  activity 
of  primitive  cells  and  of  the  structures  of  which  they  form 
a  part. 

Frequency  of  oscillation  or  alternation,  it  has  been 
shown  by  Tesla  and  others,  renders  currents  of  relatively 
large  amperage  and  high  potential  not  dangerous  to  life. 
This  seems  to  be  demonstrated  to  be  due  to  the  fact  that 
these  currents  are,  owing  to  great  frequency,  forced  to 
pass  over  the  surface  of  the  body,  or  are  widely  dispersed 
without  altering  the  superficial  structures. 


THE  PHYSICAL  EFFECTS  129 

Cauterant  effects  of  high-potential  currents  are  pro- 
duced by  discharges  derived  from  a  source  of  relatively 
large  amperage  when  brought  near  the  surface,  or  by 
successive  discharges  of  smaller  amperage  to  the  same 
area.  This  effect  is  produced  by  bringing  the  effleuve  or 
brush-discharge  from  sources  of  high  i)otential,  in  close 
proximity  to  the  tissues — holding  an  electrode  for  a  suf- 
ficient time  in  one  position.  The  destructive  actions  and 
cauterant  effects  of  these  modalities  are  of  relatively 
little  therapeutic  value,  except  possibly  when  it  is  sought 
to  destroy  local  infection,  a  neoplasm,  chondylomata,  or 
other  superficial  abnormal  i)rocess. 

Elvctrohftic  action  is  produced  to  varying  extents  by  all 
electrical  modalities,  except  possibly  those  in  which  the 
tissues  are  subjected  to  the  action  of  currents  of  but  one 
polarity,  as  the  static  wave-current  and  currents  which  do 
not  pass  into  the  body. 

With  the  currents  of  lii*iger  amperage,  however,  elec- 
trolysis is  most  potent  and  of  great  value  for  producing 
the  therai)eutic  results  which  are  sought  from  such  cur- 
rents, but  great  caution  against  the  reckless  employment 
of  currents  of  large  quantity  must  be  exercised.  In  the 
treatment  of  conditions  in  which  it  is  sought  to  improve 
metabolism  and  increase  the  activity  of  organic  functions, 
currents  which  produce  ionic  alteration  without  reference 
to  consecpience  or  selections,  as  do  currents  of  larger  am- 
perage, must  be  employed  with  caution. 

Cataphoresis,  as  produced  hy  currents  of  high  poten- 
tial, is  a  subject  upon  which  relatively  little  has  been  con- 
tributed.    It  has  been  demonstrated,  however,  by  Bishop, 


1^0  HiGfl-I>C«CE:&ITU^  £IC^^KB3:S 

Biirch,  ami.  others,  that  it  is  possible  to  introdiice  by  siich 
.ciiryents  chemical  agents  sncbasiiodiiije  into  the  tissues..  L 
-.  ij  Generg^li diffusion  qf  a  current  requires  that  it  be^  of 
.J^rly.  .high  pot^ntiaL  aad,.^fidmini^tej^ed;  tcr  a  b,Q4y  ,^.or 
■capacity^, insulated  and  c^nnecte^.fip  pJie.^i<i.e  5>i*,-pole  .o£  a 
source  of  electrical  energy.  Under  these  conditions  the 
current  should^be  of  relatively  small  amperage,  as  are  the 
static  currents;  or  possessed  of,  a  liigh  rate  Of  oscilla- 
tion or  periodicity,  when  frond  a  source' of  greater  amper- 
age." TWO  curre'nts  of  otherwise  distinctly  different  char- 
arcterfsfics— the  static  wave  current  and  the  d' Arson val 
xrurreht,  as  administered  to  the  patient  insulated  upon'  the 
insulated  platform  or  the  cushion  of  the  auto-condensation 
•e()u-Ch,'  from- a  •directional  sourde,  are  distinctly  one  pole 
^tilsatory  currents.  /     .-3::::;-i    i:i  ■£,j;:!:>;^i 

-  :  In  the  case  of  the  former,  the  staticr  wave- eurreat,  the 
electrons  are  diffused.  Attracted  to  escape  to  the.  opposite 
polarity  in  all  directions,  they  pass  under,  the  pressure 
.^f:higJi  potential  from  the  electrode  in  contact  with  the 
surface  to  immediately  surround  the  body  of  the  patient 

(see  Fig.  44) .  The  current  takes  this  course  in  fulfillment 
of  the  natural  law  by  which  currents  pass  by  the  shortest 
route,  and  best  conductor.  The  human  body  is  practically 
a  normal  salt  solution;  a  good  conductor;  wbile  the  skin 
is  a  very  poor  conductor. 

'^"Wheii  the  d^Arsonval  current 'ikadjRm'i&teted  by  the 
method  referred  to,  conditions  are  tie  same  as  with  the 
"wive  current,  in  point  of  instilation  and  a  unidirectional 
character  when  frOm  a  directional  sotirCe;  but  the  cur- 
Terits  in  other  respects  are  different. 

-  '  The  d^Arsofwal  current  is  of  much  lower  potential,  and 
.greater  amperage  than   the   static   current,   and  though 


THE  PHYSICAL  EFFECTS 


131 


derivetl  fiH)m  a  higli  fn'<iin'iuv  apparatus  is,  under  the 
conditions  described,  converted  into  a  current  of  high 
periodicity.    The  current  entering  the  body  of  the  patient, 


FiCi.  44.     yhuwiHg  the   Passage  of  the  Sfatif   Wave  Current   Through   the 

Tissues. 


if  of  as  high  potential  as  the  static  current,  would  pass 
to  and  through  the  insulating  cushion  by  the  shortest  route, 
rnder  the  characteristic  conditions,  1i(»wcv(T,  the  current 


132  HIGH-POTENTIAL  CURRENTS 

passes  through  the  body  and  is  to  a  degree  diffused. 
The  greater  condensation,  however,  must  be  present  in 
the  tissues  nearest  the  condenser  plate  beneath  the 
cushion,  as  indicated  in  Fig.  16.  In  both  cases  the  cur- 
rent is  praeticallj  unipolar,  surging  in  and  out  of  the 
patient. 

The  static  wave  current,  owing  to  the  small  amperage 
with  a  slow  rate  of  periodicity,  produces  deep  mechanical 
effects  upon  the  cells,  with  a  small  degree  of  heat  pro- 
duction. With  the  d'Arsonval  current  on  the  other  hand, 
the  periodicity  is  so  great,  that  the  action  is  largely  one 
of  heat  production,  though  the  evidence  of  increased  elim- 
ination of  the  products  of  poor  metabolism  are  found  here 
as  with  the  wave  current,  by  the  increased  elimination  of 
solids  with  the  urine  and  other  evidences  including  im- 
proved nutrition  and  changes  in  the  blood.  In  the  case 
of  the  static  wave  current  of  low  periodicity,  the  tissues 
beneath  the  electrode  are  thrown  into  active  responsive 
contraction ;  whereas,  with  the  d'Arsonval  current  admin- 
istered as  described,  no  evident  tissue  response  is  induced. 
These  two  currents,  differing  in  quality  and  effect  well 
illustrate  and  demonstrate  the  relative  effects  of  varying 
amperage  and  the  varying  effects  of  high  and  low  period- 
icity. The  effects  of  both  of  these  modalities  as  previously 
stated  have  a  remarkable  influence  upon  local  and  general 
metabolism. 

A  noted  difference  in  effect  is  also  observed  with  ref- 
erence to  their  influence  upon  blood  pressure  or  tension. 
The  wave  current  is  disposed  to  raise  arterial  tension, 
except  in  occasional  instances,  whereas  the  d'Arsonval 
current  lowers  blood  pressure  with  but  rare  exceptions. 
How  this  action  takes  place  is  difficult  to  explain ;  prob- 


THE  PHYSirAL  EFFECTS  133 

ablj,  however,  by  heat  production  or  some  direct  iiidu- 
ence  upon  the  vaso  motor  centers  and  the  musculature  of 
the  arterioles. 

Muscular  contraction  is  induced  by  all  electrical  cur- 
rents except  those  of  hig;li  periodicity  and  high  frequency 
when  applied  to  the  motor  points  or  directly  over  the 
spinal  centers,  by  direct  or  reflex  stimulation  of  a  nerve 
trunk,  or  the  end  neurons. 

Contraction  of  cell  protoi>lnsm  by  electrical  currents 
without  reference  to  the  nervous  system  has  been  un- 
questionably demonstrated,  as  all  recent  text  books  on 
physiology  attest.  All  currents  however,  except  the  high 
potential  currents,  must  be  applied  directly  to  the  cell 
to  province  rt\«ponses  except  througli  tlie  nervous  mechan- 
ism. In  other  words,  it  is  not  possible  by  the  Faradic 
or  induced  current  to  induce  such  contraction  of  the 
musculature  through  the  skin.  This  however,  is  not  the 
case  with  the  static  current  which  by  a  remarkable  ix>ten- 
tial  penetrates,  overcomes  the  resistance  of  the  skin,  and 
acts  upon  the  cells  with  great  energy.  The  high  potential 
static  modalities  induce  diffuse  contraction  wherever  ap- 
plied, without  reference  to  motor  points.  The  contraction 
so  induced  is  painless,  except  when  the  niuscles  are  in  a 
state  of  tension  or  when  api)lied  over  an  indurated  tissue. 
Care  must  be  exercistni  in  the  administration  of  tlie  static 
wave  current  in  carrying  out  this  important  principle  of 
relieving  or  removing  tissue  intiltration  or  muscular 
spasm,  not  to  overstimulate  or  fatigue  the  tis-sues.  This 
is  effecte<l,  and  with  best  results,  by  regulating  the  length 
of  the  spark-gap  that  no  muscular  spasm  will  be  produced 
and  by  not  making  the  seance  too  long.  A  rate  of  spark 
discharge  of  120  to  300  per  minute  for  iMl  minutes  gives 
the  best  average  of  results. 


134  HIGH-POTENTIAL  CURRENTS 

On  the  other  hand,  the  low  potential  currents  when  applied 
to  the  skin,  produce  a  painful  stinging  sensation  stimu- 
lating muscular  contraction  by  end  nerve  irritation,  and 
requiring,  to  produce  a  profound  muscular  contraction, 
that  the  current  be  applied  directly  to  the  motor  points — 
places  where  the  nerves  come  very  near  the  surface  of 
the  body. 

The  effleuve  as  emitted  from  the  brush-discharge, 
sprays,  and  vacuum  electrodes  are  distinctly  irritating 
to  the  surface  and  produce  a  rubefacient  condition,  and 
their  consequent  action  upon  deeper  structures  is  at  least 
in  part  due  to  reflex  stimulation. 

Local  oxidation  and  other  germicidal  action  due  to  the 
affinity  of  O3  (ozone)  for  the  organic  tissues  is  another 
action  which  is  exerted  beneficially  upon  abnormal  tis- 
sues and  the  germs  present  when  exposed  to  the  applica- 
tions of  the  effleuve  of  the  high-potential  discharges  due 
to  the  decomposition  of  the  atmosphere  and  the  products 
evolved  from  the  mingling  of  the  positive  and  negative 
electrons  in  proximity  to  the  tissues  with  the  productioji 
of  ozone,  nitrous  acid  (NO3),  water,  and  other  combina- 
tions of  less  importance.  The  characteristic  chemical 
effects  are  of  a  character  which  is  but  moderately  irritat- 
ing from  the  production  of  HoNO*  by  the  combination  of 
NO3  and  water,  which  is  produced  in  such  small  particles 
as  not  to  seriously  affect  the  tissues  if  the  administrations 
are  not  too  prolonged. 

The  vibratory  action  induced  by  the  discharges  of  high 
potential  arises  from  various  causes.  (1)  Protoplasmic 
contraction  is  produced  in  the  tissues  by  the  current  as  it 
passes.  (2)  Superficial  intense  vibration  is  exerted  by 
the  action  of  the  discharges  upon  the  patient,  insulated 


THE  PHYSICAL  EFFECTS  135 

bill  ill  the  presence  of  opposiU-lv  elKii-<i;e(I  eapiuilies,  aud 
(3)  the  interveiiin<;  skin,  which  is  a  relatively  poor  con- 
ductor, ofYers  resistance,  and  the  cnirent  passi'S  beyond 
to  a  medium  of  goml  conduction.  The  effects  are  to  set 
lx)th  the  skin  and  underlyini;  tissues  into  a  frtate  of  vil>ra- 
tion  synchronous  with  the  imitulses  of  tlie  interruption  or 
oscillation  at  the  spark-uap  durin*;;  the  administration. 
The  difference  is  niai-ked  between  the  skin  and  mucous 
membrane  the  resistance  iKMUg:  much  less  with  the  latter. 

Intense  local  vibration  is  most  niarke<l  as  produced  l»y 
the  conductive  discharges  at  the  place  of  contact  with  the 
metal  electrode  usually  employed  during  the  administra- 
tions of  the  static  induced  aud  static  wave-currents,  and 
also  with  the  conductive  featui'e  of  currents  derived  from 
the  vacuum  tul>es  connected  directly  with  the  static  ma- 
chine without  the  intervention  of  a  step-up  transformer 
or  resonator.  The  effects  of  sensible  pulsation  are  not  so 
energetically  produced  by  any  other  electrical  apparatus 
as  by  the  currents  of  the  static  machine. 

Polarization  is  one  of  the  most  diflflcult  of  the  physical 
properties  to  demonstrate.  It  has  been  shown,  however, 
by  physiologists  that  electrical  currents  in  their  passage 
through  the  tissues  induce  cell  protoplasm  to  take  spher- 
ical forms.  All  are  familiar  with  tlie  physical  demonstra- 
tion that  magnetism  and  electrical  discharges  induce 
movable  particles  of  matter  to  arrang<'  th<Mnsclves  into 
vai'ious  symmetrical  forms.  The.se  actions  signify  an  in- 
fluence of  electrical  force  by  which  mechanical  eflfects  are 
exerted. 

lonizatinn.  The  dMnonstration  by  Thomson  that  the 
passage  of  an  electrical  current   is  the  pa.ssage  of  sub- 


186  HIGH-POTENTIAL  CURRENTS 

stantial  electrons  is  certain  to  place  new  constructions 
upon  the  probable  actions  of  the  currents  upon  the  tissues. 
The  physiological  effects  of  the  various  high-potential 
modalities  derived  from  static  machines  and  coils,  either 
by  direct  connection  or  with  intervening  resonators  or 
step-up  transformers  placed  in  the  circuit,  are  practically 
based  upon  the  same  general  principles,  except  those  due 
to  individual  peculiarities,  and  have  therefore  been  classi- 
fied with  reference  to  their  characteristics  as  conductive, 
disruptive,  and  convective  discharges,  with  added  refer- 
ence to  the  various  sources  and  the  varying  conditions  of 
the  modalities.  The  effects  produced  by  these  electrical 
discharges  are  variable  with  the  different  modalities  and 
have  been  given  in  detail  in  the  preceding  chapters. 


CHAPTER  IX 

GENERAL  PRINCIPLES  GOVERNING  THE  THERAPEUTIC  APPLICA- 
CATION    OF    HIGH-POTENTIAL    CURRENTS 

The  consideratiou  of  the  physiological  actions  as  out- 
lined in  the  foregoing  chapters,  suggests  a  very  wide 
scope  of  clinical  application  for  the  high-potential  modali- 
ties. It  has  been  observed  that  these  currents  possess 
three  distinct  characteristics  of  action,  as  follows:  (1)  the 
effects  associated  with  ionization,  polarization,  and  other 
characteristic  actions  of  electricity;  (2)  other  mechanical 
effects  associated  with  muscular  and  cell  contraction 
and  vibration;  (3)  chemical  or  antiseptic  effects  char- 
acteristic of  the  convective  and  vacuimi-tube  discharges; 
and  (4)   the  thermic  effects. 

If  these  currents  are  to  aflfect  the  deeper  tissues  of  the 
patient  and  produce  a  general  effect,  it  is  necessary  either 
that  the  current  administered  be  applied  to  the  patient 
when  insulated,  and  from  one  side  of  the  source  of 
electrical  energj-  or  by  some  other  method  by  which 
it  may  be  demonstrated  to  be  diffused  throughout  the 
body. 

The  uare-current, iuhu'inisierod  as  it  is  from  one  side  of 
the  machine  with  the  patient  insulated,  induces  discharges 
which  diverge  from  the  surface  of  contact  to  the  whole 
surface  of  the  patient,  passing  through  the  tissues  of  the 
body  in  every  direction,  thereby  producing  a  general 

137 


138  HIGH-POTENTIAL  CURRENTS 

electrification.  It  is  in  this  manner  that  the  influences  of 
electricity  per  se  are  brought  to  bear  upon  the  cell  struc- 
tures throughout  the  whole  economy.  While  the  action 
upon  the  cell  is  largely  conjectured,  it  is  clinically  demon- 
strated from  this  method  of  administration  that  metab- 
olism is  increased  and  a  general  feeling  of  well-b^ing 
induced.  It  is  also  clinically  shown  that  patients  not 
affected  with  organic  lesions  when  receiving  coursesTof 
treatment,  have  the  normal  functions  of  the  systeihl 
restored.  This  is  evidenced  by  the  markedly  increased 
elimination  and  secretion,  increased' bo^. weight,!  and- -^ 
gradual  restoration  to  normal  propprtij>n§. , of  rthe elements 
of  the  blood.  These  clinical  obseryiatioiis  indicate  that;  a 
general  increase  of  cell  activity  .with-  restoration  of  their 
normal  action  is  induced.^.  When  it  is  observed  that  this 
may  take  place  regardless  of  a  regulation  of  "exercise  and 
habit,  it  would  seem  that  tliese  administratioti&  to  i^atierits 
whose  habits  and  vocations  ar6' s6d6ntary,  Vake^the  plae^ 
in  a  measure  of  phy^c'are±efMs6,^l^rob'aljly  due  to^t'fie^  in- 
duced acti\T.ty  of  the' cell;  wMeh-  tends  to  pi^serve  a- 
balance  in  the  economy  fui-nishing- a  valuable  means  of 
eliminating  effete  end  products  and  forcing  tissue  com- 
bustion. When  einployed,  hbwever,  in  c6il5tinctit>ii'-wit:li' 
exercise^  greater  benefit'may  be  dei*ived;  Tbfes^  ob^fei^va-^ 
tions  therefore  suggest  that  the  person  in  a  relative  cbil' 
dition  of  health, 'but  following'a' sedentary  life,  can  be 
greatly  benefited  by  the  regTilai'empIo>Tnenf  Of  such- ad-^ 
ministrations.  In  the  helpless  'invalid  who  is  'lihabie  td^ 
take  "exercise,  they  aire  invaluable  in  that'  tliey'  ihdtice  ha-" 
tu*e't6':ih^  aetiVe  performance's  of  her'iKJrniar  funtefioiM'? ^ 


\ 


GENERAL  PRINCIPLES  139 

It  is  observed  by»th'os<»  who  are  familiar  the  applieatioii 
of  electricity  by  the  (luto-condcnsation  method  when  ciii 
ployiug  the  eiirreuts  of  high  ix)tential  and  higli  fi*eqiiiMK-y 
or  high  pericHlicity,  that  there  is  also  an  increase  of  (he 
prcHluets  of  the  end-orgaus  ilerived  from  its  administra- 
tion. These  cnrivnts  penetrate  the  bmly  though  not  in 
the  same  manner  as  is  fully  considered  in  the  previous 
chapter. 

It  seems  to  have  bi^en  fully  demonstrated  that  und(5r 
both  types  of  administration  there  is  an  increased  elim- 
ination of  solids  in  the  urine  and  of  CO,  with  respiration, 
which  may  arise  from  a  large  degree  of  heat  production 
or  superficial  action,  and  these  superficial  currents  may 
also  reflexly  aiTect  the  deeper  structures  of  the  body  or 
induce  other  currents  in  the  body.  In  the  case,  however, 
of  a  current  administered  as  the  wave-current  is,  from  one 
side  of  the  source  of  energy  with  tlie  ]>atient  insulated, 
the  current  can  be  demonstrated  to  be  actually  driven 
through  the  tissues  in  all  directions  in  the  natural  course 
to  the  surface,  and  the  increased  elimination  so  marked 
with  this  form  of  administration  is  undoubtedly  due  to 
the  increased  activity  efTecting  an  acceleration  of  general 
metabolism,  both  eliminative  and  secretive.  These  in- 
fluences associated  with  the  passage  of  any  current 
througli  till'  tissues  are  j)roductive  more  or  less  of  elec- 
trolysis or  ionization.  The  relative  bearing  of  this  action, 
however,  upon  the  tissues  is  one  concerning  which  no  ob- 
servations except  the  clinical  results  of  their  employment 
can  be  made.  It  is  probable  that  the  cells  under  the  in- 
fluences of  the  current,  passing  with  interruptions,  is  one 
that  induces  a  change  of  form  incident  to  the  contractions 


140  HIGH-POTENTIAL  CURRENTS 

and  relaxations  of  the  cell,  and  at  the  same  time,  with  each 
recurrent  oscillation,  disposing  the  whole  organism  to  a 
state  of  general  tissue  activity. 

The  administration  of  currents  of  high  potential  which 
flow  between  the  terminals  of  the  two  opposite  polarities 
certainly  pass  in  narrow  lines  through  the  tissues  to  com- 
plete the  circuit.  The  greater  the  potential  or  voltage  of 
the  current,  the  more  direct  will  be  these  lines  of  passage 
between  the  two  opposite  polarities.  The  passage  is  com- 
parable to  a  stream  of  water  passing  down  a  hillside  or 
through  a  sandy  plain.  In  one  case,  the  channel  will  be 
very  narrow  and  straight  and  only  to  a  small  degree 
saturate  the  banks,  while  the  same  stream,  passing  across 
a  nearly  level  plain,  will  be  tortuous  and  largely  absorbed 
during  its  passage.  This  comparison  would  serve  to  in- 
dicate the  different  methods  of  passage  of  currents  of 
high  potential  in  comparison  with  the  continuous  current 
of  low  potential  which  is  known  to  spread  out  through  the 
tissues  during  its  passage.  One  other  observation  in  re- 
lation to  these  two  types  of  current  should  be  made,  and 
that  is  that  the  current  of  low  potential  is  disposed  always 
to  follow  the  tracks  of  best  conduction,  as  the  muscles  or 
blood  vessels  of  the  body,  while  the  currents  of  high- 
potential,  displacement-currents,  pass  across  and  through 
tissjues  of  slightly  varying  resistance  in  comparatively 
straight  lines.  The  greater  the  quantity  of  the  current 
passing,  the  greater  will  be  the  ionization  or  electrolytic 
action  upon  the  tissues,  except  of  high  potential  currents 
of  high  frequency,  which  have  been  demonstrated  to  pro- 
duce no  electrolysis,  but  thermic  effects. 


GENERAL  PRINCIPLES  141 

Thi'  mechanical  effects  of  lii^h-poti'iitial  (nirrente  iniist 
be  deemed  of  gixiat  importance  from  the  therapeutic  point 
of  view,  and  may  be  exerted  either  directly  or  reflexly,  ac- 
cording to  the  modality  employed.  The  direct  effects  of 
these  currents  are  derived  from  the  conductive  dis- 
charges, producing  distinct  muscular  contraction  and  vi- 
bration, and  undoubted  contraction  of  cell  protoplasm 
from  their  application.  These  effects  from  the  conduct- 
ive discharges  are  very  largely  local,  being  transmitted 
from  the  surface  to  a  depth  relative  to  the  amplitude  or 
potential  of  delivery  of  the  current,  which  is  varied  by 
changing  the  length  of  the  spark-gap. 

21ie  term  potential  of  delivery  is  one  which  the  author 
has  adopted  to  express  a  condition  of  electrical  discharges 
which  should  be  defined,  and  for  which  there  is  no  term  in 
common  use  to  designate.  By  it  is  meant  the  amplitude 
or  spark  length  possible  to  deliver  under  the  conditions 
of  a  circuit  from  a  discharging  electrode  to  the  site  of 
application.  The  potential  of  delivery  will  depend  upon 
the  length  of  the  spark  between  the  rods  of  the 
condensers,  plus  the  potential  added  by  a  step-up 
transformer;  the  length  of  an  effleuve  of  a  convective 
character;  or  the  length  of  spark-gap  or  the  amplitude  of 
the  conductive  discharges  which  are  measured  by  the 
spark-ga}).  The  size  of  the  Leyden  jars  in  the  circuit  of 
the  current  also  varies  the  j)Ossibilities  of  the  amplitude. 
The  necessity  for  the  employment  of  the  term  potential  of 
delivery  arises  from  the  confusion  that  exists  at  this  time 
with  reference  to  the  action  of  high-frequency  and  pulsa- 
tory  currents.     Too   little   attention   has   been   ])aid   to 


142  HIGH-POTENTIAL  CUKRENTS 

the  fact  that  when  rapid  intermptions  are  made  in  the 
circuit  of  a  current  pulsatory  or  oscillatory,  that  the 
periodicity  is  at  the  expense  of  the  spark  length  possible 
if  a  brake  is  made  in  the  circuit.  Potential  of  discharge 
is  shortened  to  produce  a  high  rate.  The  spark  discharg- 
ing between  the  jars  of  the  resonator  of  a  high-frequency 
apparatus  will  be  relative  in  rate  to  the  length  of  the 
spark  discharging,  other  things  being  equal.  The  length 
of  a  spark  discharged  from  an  electrode  connected 
with  the  circuit  will  represent  the  potential  of  deliver!/. 
In  other  words,  when  administering  a  spark  from  a 
solenoid  or  Telsa  coil  or  a  combination  of  the  two  in  con- 
nection with  the  outer  coating  of  the  two  condensers  of  a 
static  machine,  a  spark  will  be  delivered  relative  to  the 
length  of  the  spark-gap,  and  of  a  rate  of  discharge  in- 
creasing as  the  spark  length  is  diminished  or  the  rate 
of  revolution  of  the  plates  of  the  machine  is  increased, 
plus  an  increase  of  potential  developed  in  the  solenoid. 
It  will  be  seen,  then,  that  the  rate  of  interruption  is 
increased  at  the  expense  of  the  potential  of  delivery. 
When,  therefore,  the  fact  is  recognized  that  the  intensity 
and  the  depth  of  perturbatory  effect  of  a  discharge  de- 
pend upon  its  potential  of  delivery,  and  not  upon  the  fre- 
quency of  interruption,  other  things  being  equal,  the  im- 
portance of  the  designation  and  differential  relations  of 
potential  and  the  rate  of  interruption  can  but  be  appre- 
ciated. The  rate  of  interruption  bears  the  same  relation 
of  inverse  ratio  to  the  potential  of  delivery  in  electro- 
therapeutics as  speed  does  to  power  in  mechanics.  In 
the  consideration  of  the  mechanical  effects  of  the  elec- 


I 


GENERAL  PRINCIPLES  143 

trical  discharges  conductive,  disruptive,  or  convective, 
the  importance  of  the  bearing  of  these  considerations  can 
be  easily  appreciated.  The  mechanical  effects  of  the  cur- 
rents of  high  frequency  except  when  painful  in  character, 
as  are  the  sparks,  or  effleuve,  and  the  possible  action  upon 
the  cell  due  to  the  influence  of  the  passage  of  an  electrical 
current  ns  considered,  are  otherwise  practically  nil.  In 
other  words,  the  currents  of  very  high  rates  of  interrup- 
tion— pulsatory  or  oscillatory — are  deficient  in  ampli- 
tude, do  not  produce  muscular  contraction,  and  are  abso- 
lutely painless  during  administration.  With  them  the 
potential  of  delivery  is  very  small.  The  mechanical 
effects  of  such  currents  are  therefore  insignificant  or  of 
no  value.  The  following  conclusions  as  to  the  actions  of 
high-potential  discharges  constitute  a  basis  for  their 
mechanical  employment  in  therapeutics. 

(1)  Currents  derived  from  the  static  machine  have 
striking  characteristics  producing  mechanical  effects 
upon  the  tissues  diffused,  penetrating  and  painless, 
peculiar  to  these  currents.  When  carried  to  the  point  of 
inducing  tetanus,  or  when  administered  over  inflam- 
matory areas,  their  action  may  also  become  painful. 

(2)  Secondary  mechanical  effects  are  undoubtedly  pro- 
duced upon  the  tissues,  which  give  tone  to  the  muscular 
structures,  and  others  probably  of  polarization. 

(3)  Muscle  and  tissue  contractions  are  produced  by  all 
disruptive  and  convective  discharges  relative  to  their  in- 
tensity or  irritating  characteristics,  and  varying  in  pene- 
tration with  the  potential  of  delivery  of  the  discharges, 
other  things  being  equal. 


144  HIGH-POTENTIAL  CUKRENTS 

Polarity.  In  the  administration  of  the  high-frequency 
currents — alternating  in  character — consideration  of 
polarity  does  not  enter.  Such  currents,  as  the  designa- 
tion implies,  are  alternately  positive  and  negative  at  the 
two  terminals  of  the  circuit.  This  is  objectionable,  when 
it  is  a  well-recognized  fact  that  with  unidirectional  cur- 
rents the  local  actions  of  the  opposite  polarities  produce 
positively  different  effects. 

In  the  local  administrations  of  the  wave-current  in  the 
treatment  of  acute  inflammatory  conditions,  the  writer 
has  demonstrated  repeatedly — often  enough  to  establish 
the  fact — that  the  wave-current  derived  from  the  nega- 
tive side  of  the  static  machine  when  applied  over  such 
regions,  while  producing  a  temporary  sedative  effect,  is 
followed  after  a  short  time  by  marked  aggravation  of  a 
condition  which  had  been  improving.  It  has  occurred  in 
a  sufficient  number  of  instances  during  previous  years 
when  the  polarity  was  looked  upon  as  an  indifferent  fac- 
tor to  finally  demonstrate  the  fact. 

One  well-marked  instance  will  serve  to  illustrate  the  ag- 
gravating effect  of  the  use  of  the  wave-current  connected 
directly  to  the  negative  side  of  the  machine.  A  patient 
who  had  been  treated  for  three  days  for  an  acute  sciatica 
of  a  very  severe  type,  in  which  the  condition  had  been  so 
greatly  improved  that  he  had  slept  the  night  previous  to 
the  fourth  administratiou,  was  treated  by  an  assistant. 
He  connected  the  patient  with  the  negative  side  of  the 
machine,  the  positive  being  grounded,  and  administered 
the  wave-current  for  the  usual  period  of  fifteen  or  twenty 
minutes.    The  patient  left  the  office  in  a  seemingly  com- 


GENERAL  PRINCIPLES  145 

fortable  condition,  without  pain.  On  the  following  morn- 
ing it  was  with  difficulty  that  he  could  return  to  the  office, 
requiring  assistance  to  get  on  and  off  the  cars  and  into 
the  house  for  treatment.  The  wave-current  was  then  ap- 
plied in  the  usual  manner  connected  with  the  positive  side 
of  the  machine,  after  which  the  ])atient  left  the  house  with 
no  vestige  of  pain  or  suffering  and  continued  the  course 
of  his  treatments  for  three  days,  when  the  recovery  was 
complete.  Similar  results  have  occurred  in  other  cases 
in  which,  with  the  use  of  the  positive  current,  uniformly 
sedative  results  are  obtained.  It  is  the  local  action,  espe- 
cially in  the  treatment  of  inflammatory  processes,  where 
the  polarity  plays  such  an  important  part.  It  would  also 
seem,  and,  so  long  experience  has  taught  the  writer,  that 
the  positive  electrons  exert  a  more  favorable  influence 
upon  the  general  metabolism.  Comparisons,  however, 
of  the  two  polarities  have  not  been  made  as  to  the  consti- 
tutional effects  of  the  current,  as  the  negative  has  been 
but  little  used  in  these  conditions.  From  the  positive, 
however,  are  always  obtained  desirable,  sedative,  and 
quieting  effects  which  seem  to  indicate  its  employment,  if 
not  its  choice,  to  the  exclusion  of  the  negative,  for  favor- 
ably affecting  the  nutritive  processes  of  metabolism. 

The  application  of  the  brush-discharge,  wWh  the  patient 
connected  to  the  negative  side  of  the  Holtz  machine,  is 
distinctly  soothing  to  a  painful  and  inflamed  condition, 
as  may  be  easily  demonstrated.  When  a  connection  is 
made  directly  to  the  positive  side,  however,  the  effect  is 
distinctly  irritating.  This  is  not  only  the  effect  at  the 
time  of  an  administration,  but  the  writer  has  been  con- 


146  HIGH-POTENTIAL  CURRENTS 

vinced  after  a  series  of  experiments  that  an  application 
with  the  patient  attached  to  the  positive  side,  will  be  fol- 
lowed by  a  recurrence  of  the  symptoms  a  short  time  after 
the  close  of  the  administration,  whereas,  when  the  applica- 
tion is  made  with  the  patient  connected  to  the  negative 
side  of  the  machine,  the  effects  are  soothing  and  sedative 
and  the  relief  of  the  inflammatory  process  from  a  proper 
administration  is  prolonged,  tending  to  the  recovery  of 
the  condition.  This  unquestioned  local  action  in  connec- 
tion with  the  administration  of  the  brush-discharge 
proves  clinically  the  certain  indication  for  the  choice  for 
the  connection  of  the  patient  with  the  negative  pole  dur- 
ing this  form  of  administration. 

With  the  vacuum  tubes  applied  directly  to  the  surface 
of  the  patient,  the  choice  of  polarity  is  to  some  extent  an 
open  question,  but  from  recent  results  it  seems  to  have 
been  demonstrated  that  the  connection  made  to  the  posi- 
tive side  of  the  Holtz  machine  is  the  choice  for  the  treat- 
ment of  local  inflammatory  conditions,  where  it  is  sought 
to  allay  the  induration  and  restore  an  active  metabolism. 
When  the  indications  are  for  the  treatment  of  local  septic 
conditions,  however,  or  where  germs  are  present  in  the 
superficial  tissues,  the  greater  chemical  action  at  the  sur- 
face of  the  glass  when  connected  with  the  negative  side 
would  indicate  the  connection  with  that  side  for  the  treat- 
ment of  such  conditions.  In  this  connection  it  is  well  to 
state  that  the  effects  of  muscular  contractions  are  induced 
with  a  great  deal  more  energy  with  the  same  length  of 
spark-gap  when  the  vacuum  tube  is  connected  with  the 
positive  side  of  the  Holtz  machine,  than  with  the  negative, 


GENERAL  PRINCIPLES  147 

and  also  that  greater  enerjjy  is  exerted  when  there  is  a 
leading-in  ^ire  in  the  electrode. 

These  effects  suggt'^t  an  important  consideration  of  the 
actions  of  the  elet-trons  in  their  passage,  hut  leave  an  ele- 
ment of  doubt  from  the  fact  that  when  the  brush-discharge 
is  employed  there  is  a  passage  by  induction  through  and 
to  the  place  of  discharge  of  negative  electrons,  while  with 
the  wave-current  tlu'  passage  of  the  current  surging  to 
and  fro  is  of  positive  electrons.  In  one  instance  the 
consideration  is  given  entirely  to  the  one  polarity  a»  it 
affects  the  surface  during  its  escape,  whereas,  in  the  other 
insrtance,  the  opposite  polarity  produces  the  greater  degree 
of  sedative  effect. 

The  explanation  of  these  two  opposite  effects  from  dif- 
ferent polarities  is  diflScult  to  reconcile,  and  yet  from 
clinical  experience,  which  is  the  best  proof,  the  truth  is 
demonvstrated  in  every  instance  where  a  careful  study  of 
the  relative  effects  is  made.  So  much  of  the  action  of 
these  electrons  upon  the  tissues  is  still  unexplained,  that 
the  clinical  results  obtained  may  lead  to  final  conclusions 
which  may  clear  up  or  explain  many  of  these  actions. 

The  explanation  of  the  differences  of  thesH^  effects  must 
be  made,  not  from  effects  of  the  passage  of  the  current, 
but  probably  from  the  irritating  action  of  the  positive 
discharges  of  the  brush-discharge  upon  the  end-organs, 
which  is  easily  demonstrat«xl  by  any  observer. 

The  polar  effects  of  the  d'Arsonval  current  as  admin- 
istered with  auto  condensation  have  not  been  generally 
appreciated.  This  current  when  administered  from  a 
unipolar  source,  i.  e.,  with  an  arrangement  which  will 
vary  with  the  length  of  tin*  spark-gap,  an<l  other  ad- 
justment of  the  source  of  the  current  charging  the  reson- 


148  HIGH-POTENTIAL  CURRENTS 

ator  iS'  rendered  a  unidirectional  or  pulsatory  current. 
When  derived  from  a  static  machine  or  Ruhmkorff  coil,  or 
other  apparatus  which  gives  a  relatively  unipolar  current, 
the  resistance  of  the  spark-gap,  and  of  the  cushion  on  the 
couch,  and  the  capacity  of  the  patient,  the  current  is 
converted  into  a  pulsatory  current  of  high  periodicity. 
Such  a  current  is  practically  unipolar  in  character,  with 
the  polarity  regulated  by  changing  sides  with  the  d'Arson- 
val.  In  the  writer's  experience,  the  d'Arsonval  current 
administered  by  auto-condensation  produces  its  best  effects 
upon  metabolism  and  in  arterial  hypertension  when  ad- 
ministered with  the  positive  to  the  patient.  In  this  effect 
it  naturally  corresponds  in  its  action  with  the  effects  of 
the  positive  pole  of  the  static  wave  current. 

The  thermic  effect  of  the  high  frequency  currents  when 
administered  by  the  direct  d'Arsonval  method,  that  is  by 
the  passage  of  the  current  through  the  patient  directly 
between  two  electrodes  placed  upon  the  surface,  produces 
a  remarkable  action  upon  the  intervening  tissues,  by  the 
induction  of  hyperemia.  By  this  means  it  is  possible  to 
derive  remarkable  effects  in  the  treatment  of  infection 
and  conditions  associated  with  impaired  metabolism. 
Probably  no  therapeutic  measure  offers  greater  possibili- 
ties than  this  method  of  local  treatment  by  hyperemia. 
The  current  in  this  event  is  largely  oscillatory  as  is  char- 
acteristic of  the  d'Arsonval  current  when  administered 
with  electrodes  from  the  two  poles  in  contact  at  two  places 
upon  a  conducting  body. 

From  the  therapeutic  point  of  view,  the  importance  of 
muscular  and  cell  contraction  and  of  vibration  is  of  the 
greatest  importance.  The  latter  is  so  closely  allied  to 
muscular  contraction  as  an  effect  that  it  is  difficult  to  dis- 


GENERAL  PRINCIPLES  I4i) 

cover  a  distinct  differentiation.  It  will  be  generally 
appreciated  that  most  diseases  arise  from  functional 
inactivities  associated  with  lii/percrtnia,  passive  or  active, 
and  congestive  processes  induced  by  irritants  whicli  ap- 
pear in  the  form  of  germs,  the  i)roducts  of  auto-infection, 
results  of  poor  metabolism,  or  as  the  effects  of  trauma- 
tism. These  conditions  as  stated  are  associated  either 
with  a  degree  of  sluggish  activity  or  with  a  condition  of 
induration  associated  with  local  stasis. 

In  nature's  method  of  walling  off  processes  of  infec- 
tion, stasis  is  established  and  serves  a  valuable  purpose, 
when  infection  is  present.  The  same  induration  whicli  is 
nature's  wall  of  safety  against  the  spread  of  infection  is 
the  greatest  obstacle  to  recovery  in  other  inflammatory 
affections.  To  relieve  these  conditions  of  local  stasis  or 
induration,  which  interfere  with  the  restoration  of  nor- 
mal circulation  and  ultimate  absolute  restitution,  some 
energetic  means  is  required.  If  the  affected  area  is  super- 
ficial, the  application  of  a  mechanical  means  will  act  as  a 
vis-a-tergo,  overcoming  the  induration,  softening  the  tis- 
sues, and  thereby  restoring  circulation  and  permitting  the 
elimination  of  accumulated  infiltration,  and  other  prod- 
ucts of  an  inflammation.  It  can  but  ajij^eal  to  the  mind  of 
the  intelligent  reader  that  such  a  procedure  is  indicated 
before  a  normal  restoration  can  follow. 

Induration  promptly  follows  trauma,  as  a  sprain. 
The  blood  rai)idly  accumulates,  and  the  tissues  become 
hard,  swollen,  and  indurated,  with  the  ultimate  establish- 
ment of  what  will  become  a  chronic  stiffening  and  imjjair- 
ment  of  the  functions  of  the  ]iart.    Thus,  in  conse<iuence 


150  HIGH-POTENTIAL  CURRENTS 

of  a  shock  sustained  by  the  exposed  tissues,  dilatation  of 
the  capillaries  and  blood  vessels,  with  the  determination 
of  an  excessive  quantity  of  blood  to  the  part,  becomes  the 
first  step  towards  the  establishment  of  a  chronic  process. 
Nature  has  provided  an  increased  blood-supply  whenever 
an  accident  occurs  in  the  tissues  and  repair  is  necessary. 
Under  physiological  conditions  without  the  production  of 
shock  or  severe  injury,  a  compensatory  supply  of  blood 
enlarges  and  develops  the  part,  which  is  called  into  most 
energetic  action;  but  if  an  accident  occurs  which  results 
in  an  excessive  supply  for  which  there  is  not  a  corre- 
sponding demand,  as  above  stated,  swelling  and  indura- 
tion result.  For  the  removal  of  such  a  condition  no 
compensatory  action  is  provided,  and  local  stasis,  which 
will  become  a  chronic  inflammatory  process,  is  established. 
The  application  of  mechanical  measures  for  the  relief  of 
local  stasis,  as  it  occurs  either  in  association  with  trauma 
or  infective  processes,  may  be  followed  by  prompt  restora- 
tion. When,  however,  induration  walls  off  cavities  of  in- 
fection where  considerable  pus  is  already  present,  to  re- 
move the  induration  would  be  to  extend  the  infection. 

While  the  application  of  other  mechanical  measures  to 
conditions  of  stasis  will  induce  circulatory  drainage  to  a 
certain  degree  and  re-establish  to  some  extent  the  normal 
processes,  their  action  is  far  less  satisfactory  than  the  ap- 
plication of  the  high-potential  electrical  currents;  (1)  be- 
cause they  do  not  produce  contraction  of  the  tissues  to 
the  extent  that  it  is  produced  by  an  electrical  current; 
(2)  because  the  contraction  induced  by  an  external  me- 
chanical stimulus,  not  electrical,  has  not  the  same  tend- 


GENERAL  PRINCIPLES  151 

ency  to  preserve  a  prolonged  state  of  contraction;  (3) 
because  the  penetrating  effect  and  diffuse  action  of  the 
mechanical  applications  referred  to  are  not  such  as  to 
envelop  and  include  all  of  the  structures  involved,  and 
(4)  their  application  is  generally  too  painful  in  acute  con- 
ditions to  ])ermit  the  production  of  complete  relief  of  the 
local  condition. 

The  modus  operandi  of  the  high-potential  electrical  ap- 
plications of  moderate  rates  of  interruption,  as  applied 
to  the  treatment  of  acute  congestion,  is  to  stimulate  the 
tissues  to  contraction,  alternating  with  periods  of  relaxa- 
tion. The  induction  of  contraction,  interrupted  at  inter- 
vals not  too  frequent,  reduces  a  process  of  inflammation 
to  normal.  The  flow  of  blood  in  the  parts  is  thus  restored 
and  the  activities  of  the  hinphatics  and  end-organs  which 
under  pressure  were  in  condition  of  stasis  are  restored. 

It  will  be  readily  appreciated  when  an  electrical  stimu- 
lus is  administered  in  the  manner  described,  before  much 
pus  has  formed  in  a  commencing  abscess,  as  of  tonsilitis, 
felon,  or  carbuncle,  it  will  overcome  the  local  stasis,  and  at 

the  same  time  increase  the  local  leucocytosis  and,  causing 
mmxi  acti\'ity  locally  of  the  phagocytes,  will  carry  away* 
the  foci  of  infection  and  relieve  a  condition  which  would 
otherwise  be  followed  by  a  painful  jH'ocess.  This  is  un- 
doubtedly the  method  of  action,  under  a  systematic  ap- 
plication of  the  proi)er  high-potential  modalities  to  acute 
inflammatory  processes. 

In  cases  of  mechanical  injuri/,  in  whicJi  no  fori  of 
infection  are  present,  but  a  condition  of  injury  to  the  soft 
parts,  the  effect  of  rclicvinsr  the  local  conpestiou   is  all 


152  HIGH-POTENTIAL  CURRENTS 

that  is  required  to  relieve  a  process,  which,  if  treated  by 
other  methods,  will  generally  become  chronic  and  be  fol- 
lowed by  months  or  years  of  suffering  and  inconvenience. 
"When  it  is  generally  recognized  that  mechanical  action  is 
necessary  to  restore  the  normal  circulation  to  an  inflamed 
tissue ;  that  its  employment  is  the  step  of  first  importance 
for  the  relief  of  a  non-infective  or  the  early  stage  of  an 
infected  process;  and  that  the  action  of  high-potential 
discharges  of  low  rates  of  interruption,  which  produce 
the  effects  of  muscular  and  tissue  contraction,  are  indi- 
cated, uncured  non-infective,  chronic  inflammatory  con- 
ditions will  be  rarely  encountered. 

In  chronic  conditions  in  which  the  early  application  of 
proper  treatment  has  been  delayed,  the  relief,  while  gen- 
erally certain  if  persevered  in,  is  not  prompt  because  the 
products  of  inflammation  have  become  more  or  less  organ- 
ized, and  deposits  of  fibrin,  and  round-cell  infiltration, 
and  other  products  of  inflammation,  have  become  so  ex- 
tensive in  the  area  that  for  their  elimination  a  longer  time 
will  be  required.  Furthermore,  when  anchylosis  is  pres- 
ent, except  in  the  superficial  regions,  little  can  be  ex- 
pected from  the  high-potential  treatment  unless  the  ad- 
hesions are  first  broken  up,  after  which  no  means  offer 
greater  promise  for  subsequent  relief  and  cure  of  chronic 
joint  affections  than  the  various  applications  of  the  high- 
potential  currents  and  other  modalities.  In  these  cases, 
however,  the  long  static  sparks  and  wave-current  admin- 
istered with  a  very  long  spark-gap  are  requisite,  because, 
in  order  to  overcome  the  chronic  induration,  very  pene- 
trating effects  are  required.    In  the  author's  experience, 


GENERAL  PRINCIPLES  153 

few  joint  affections  where  anchylosis  or  erosion  has  not 
occurred  and  no  active  germ  process  is  present,  will  fail 
to  respond  to  the  systematic  administration  of  high- 
potential  electricity.  In  enlarged  or  congested  glandular 
conditions  resulting  from  poor  metabolism,  or  the  pres- 
ence in  the  tissues  of  effete  materials,  substances  that 
have  not  been  eliminated,  these  high-potential  currents 
are  as  a  rule  effective. 

It  is  a  recognized  fact  with  those  who  are  familiar  with 
the  uses  of  these  modalities,  that  in  glandular  conditions, 
where  hyperplasia  or  some  organic  destruction  has  not  al- 
ready taken  place,  it  is  possible  by  the  mechanical  action 
of  these  currents  to  restore  in  whole,  or  part,  normal  con- 
ditions, and  that  in  cases  in  which  an  organic  process  of 
a  slow  inflammatory  character  is  in  progress,  it  is  often 
possible  to  abate  it,  allay  its  progress,  and  remove  the 
inflammatory  exudates  that  are  present,  thereby  largely 
improving  the  local  conditions.  This  is  notably  true  in 
prostatitis.  In  hypertrophic  cirrhosis  of  the  liver,  chronic 
diffuse  nephritis,  chronic  parenchymatous  nephritis,  in 
the  early  stages,  and  also  in  affections  of  the  spleen,  pan- 
creas, and  other  glands  of  the  body,  the  principles  enun- 
ciated indicate  their  employment,  and  results  obtained 
have  demonstrated  their  utility. 

The  potential  of  deliveri/,  in  all  cases,  must  be  relative 
to  the  depth  at  which  the  lesion  is  seated,  or  the  volume 
of  the  structure  affected,  and  the  results  of  their  adminis- 
tration will  depend  upon  the  possibility  of  transmitting 
the  electrical  vibration  and  tissue  contraction  to  the  re- 
motest part  of  the  affected  organ  or  region.    This  will  de- 


154  HIGH-POTENTIAL  CURRENTS 

mand  in  many  cases  the  administration  of  very  long 
sparks,  or  the  use  of  a  very  long  spark-gap  in  connection 
with  the  conductive  discharges.  The  modalities  which 
partake  of  these  qualities,  producing  muscular  and  tissue 
contraction,  are  the  currents  controlled  to  low  rates  of 
interruption,  as  the  static  wave-current  and  the  static 
induced  current,  and  the  stimulating  reflex  effects  of 
the  direct  sparks  from  the  static  machine  and  to  a 
lesser  degree  the  high-potential  sparks  from  the  reso- 
nator, or  solenoid  in  connection  with  coil  or  static 
machine.  The  vacuum  tubes,  when  employed  in  connec- 
tion with  the  static  machine,  also  produce  distinct  vi- 
bratory action  and  contraction,  whereas,  from  coil  sources 
the  only  effects  of  tissue  contraction  produced  are  those 
which  are  induced  by  the  irritating  effects  of  the  dis- 
charges with  the  production  of  reflex  contraction,  without 
the  distinct  vibratory  influence.  It  will  be  seen,  therefore, 
that  for  the  treatment  of  inflammatory  conditions  in 
which  the  intent  of  the  administration  is  to  produce  cir- 
culatory drainage  and  local  elimination,  it  is  best  stimu- 
lated by  the  induction  of  tissue  contraction  and  local  vi- 
bration, which  are  effected  most  energetically  with  the 
currents  of  lower  rates  of  interruption  and  high  poten- 
tial. 

Too  much  emphasis  cannot  be  put  upon  the  value  of 
these  mechanical  effects  of  high-potential  electricity, 
which  have  been  generally  ignored  by  writers  in  the  past. 

By  the  rational  employment  of  these  modalities  it  has 
been  already  demonstrated  that  numerous  chronic  condi- 
tions can  be  alleviated  and  the  normal  local  circulation 


GENERAL  PRINCIPLES  155 

and  initrition  restored  to  the  parts  when  other  means  have 
failed. 

The  treatment  of  infectious  diseases  by  high  potential 
currents  must  be  managed  from  an  entirely  different  point 
of  view  than  the  treatment  of  <tther  inflaniinatory  ccukH- 
tions.  The  abscess  has  been  opened  when  fluctuation  was 
present  and  treatment  confined  to  the  use  of  means  that 
favored  the  development  of  tlie  pus  process,  "  bringing  it 
to  a  head "  as  was  the  common  expression.  More  re- 
cently a  crucial  incision  and  the  injection  of  carbolic  acid 
has  been  employed  to  abort  a  boil  or  carbuncle — a  painful 
process  and  not  always  successful.  Since  the  demonstra- 
tions of  Metchnikoff,  Wrig'ht,  and  others  of  the  certain 
functions  of  the  microphages  and  the  macrophages — ^the 
leucocytes  and  the  tissue  cells,  the  management  of  infec- 
tious conditions  has  bei'ome  constantly  more  rational.  It 
will  be  recalled  by  every  physician  who  has  employed 
agents  which  produce  a  diffuse  hyperemia  in  an  infected 
tissue,  that  it  has  bt^n  possible  in  some  in.stances  to  abort 
abscess  proct^ses.  The  prolonged  application  of  heat  at 
high  temperatures  in  connection  with  other  counter  irri- 
tants which  produce  locally  an  intense  hyperemia,  in- 
creases in  the  tissues  involve<l,  by  increasing  the  blood 
sux)ply,  a  relatively  larger  number  of  phagocytes.  It  is 
this  principle  which  is  taken  advant^ige  of  in  the  treatment 
of  infection  with  the  high  p<jtential  currents. 

Methods  inducing  hypercmid  with  the  high  jmtential 
currents  are  (1)  those  which  act  superficially,  as  the 
va<'uum  tubes  or  ettieuves — <lischarges  which  on  account 
of  their  irritating  or  stinging  character  induce  a  liberal 
influx  of  blood  into  the  tissues;  and  (2)  the  high  potential 
current  of  liigh  freijuency  or  high  pi'ri<Mlicity  and  fairly 


156  HIGH-POTENTIAL  CURRENTS 

large  amperage,  which,  when  passed  directly  through  an 
infected  tissue,  induces  a  degree  of  heat  in  the  interpolar 
tissues.  Naturally  when  a  tissue  is  heated  blood  flows 
in  through  the  dilated  capillaries  to  maintain  a  uniformly 
normal  temperature.  By  this  means  a  continued  passage 
for  from  ten  to  twenty  minutes  of  a  direct  d'Arsonval 
current  through  the  infected  tissues  is  capable  of  inducing 
a  marked  hyperemia  in  the  parts  intervening  between  the 
surfaces  to  which  the  two  electrodes  are  applied,  thereby 
effecting  even  in  the  deeper  structures  a  heating  of  the 
tissues  which  will  persist  for  some  time  after  discontinu- 
ance of  the  administration.  These  and  the  application  of 
radiant  light  and  heat  which  penetrates  deeply  into  the 
tissues  with  a  conversion  of  the  radiant  energy  into  heat 
units,  are  the  two  most  important  means  of  inducing  deep 
hyperemia. 

The  Roentgen  ray  must  he  considered  here  in  connec- 
tion with  the  treatment  of  infection,  though  but  a  product 
of  the  high  potential  currents.  Its  characteristics  are 
such  that  its  influence  upon  germ  life  is  most  remarkable, 
seemingly  sterilizing,  not  destroying  the  germs  in  the  field 
of  infection,  when  the  dose  is  large  enough  or  when,  ad- 
ministered intermittently  for  a  long  enough  period  of  time. 
In  the  active  processes,  as  those  of  streptococcic  or 
staphylococcic  infection,  the  dose  should  always  be  a  mas- 
sive one;  i.  e.,  it  should  be  applied  for  a  longer  time  if 
a  moderate  radiation  is  employed,  or  otherwise  for  a 
relatively  shorter  time.  In  the  terms  of  Saboraud,  a  full 
Saboraud  dose  should  be  applied  directly  to  a  carbuncle 
or  abscess,  or  a  twenty  to  forty  minute  application  of  the 
usual  x-ray  dose,  that  is  used  for  the  treatment  of  epith- 
elioma, on  alternate  days  of  ten  minutes  each.     The  in- 


GENERAL  PRINCIPLES  157 

hibitory  effect  of  such  a  dose  of  x-rays  is  remarkable  in 
its  action  upon  germ  life.  It  should  be  followed  in  twelve 
to  twenty-four  hours  hy  an  energetic  use  of  radiant  light 
and  heat  and  high  frecjuency  currents — sufficient  to  main- 
tain a  profound  hyperemia  in  the  infected  tissue.  Such 
procedure  is  usually  effective  in  aborting  a  local  pus  pro- 
cess when  tlu»  opsonic  index  is  normal.  In  the  treatment 
or  tubercular  adenitis,  a  similar  routine  may  be  followed 
with  the  persistent  use  of  the  high  fr<H]uency  current  and 
radiant  light  and  heat,  following  a  prolonged  dose  of  the 
x-ray,  until  the  process  is  entirely  arrested.  It  should 
always  be  borne  in  mind  that  radiant  light  and  heat  and 
the  high  frequency  currents  likewise  have  an  inhibitory 
effect  upon  germ  life,  and  coincidently  increase  the  per- 
centage of  hemoglobin  in  the  blood,  and  often  with  it  the 
establishment  of  a  higher  opsonic  index. 

The  local  antiseptic  or  germicidal  action  of  the  high 
potential  discharges,  either  from  eflfleuves  or  vacuum  tubes, 
is  limited  to  the  action  locally  when  kept  up  for  consid- 
erable time.  It  is  questionable  whether  the  effects  j)ene- 
trate  deeply  into  the  tissue.  Added  to  these  are  the  effecta 
of  the  higher  frequencies  of  light,  particularly  th<'  violet 
and  ultra-viole't  associated  with  the  emanations  from  these 
discharges.  It  has  also  l)eeu  demonstrated  that  certain 
chemical  substances  as  iodine  ami  the  essential  oils  are  to 
an  extent  taken  up  by  the  tissues  through  the  medium  of 
the  vacuum  tube  discharges. 

The  production  of  an  oxidizing  agent  so  rich  in  ozone, 
in  proximity  with  the  germs,  insures  a  certiiin  amount  of 
destructive  action  fnun  that  .source.  So  also,  the  nitrous 
oxides  which  are  derived  from  these  discharges  are  anti- 
septic in  action.     It  must  be  recognized,  however,  that  the 


158  HIGH-POTENTIAL  CURKENTS 

action  of  these  discharges  is  very  superficial;  for  the  dis- 
charges from  the  tissues  take  place  from  the  most  super- 
ficial points  and  are  also  produced  in  the  interyals  between 
the  vacuum  tubes  and  the  tissues  or  in  the  spaces  between 
the  surface  and  the  electrodes  employed  in  the  administra- 
tion of  the  convective  discharges. 

It  cannot  be  presumed  that  any  spark  discharge  takes 
place  within  the  tissues  of  the  patient,  nor  in  any  case 
has  it  been  demonstrated,  that  the  chemical  effects  of  the 
discharges  are  to  a  considerable  extent  conveyed  beneath 
the  surface  except  by  the  immediate  effect  of  the  action 
of  these  agents  upon  the  blood  in  the  most  superficial 
capillaries.  The  extent  of  their  actions  show  that  so  far 
as  the  effect  upon  the  germs  is  concerned,  the  action  is  local 
and  very  limited.  To  effect  anything  like  a  therapeutic 
result  upon  the  integument  or  a  mucous  surface  the  elec- 
trode, if  a  vacuum  tube  is  employed,  must  be  in  close  con- 
tact with  the  tissues. 

The  radiant  energy  induced  by  the  electrical  discharges 
has  an  undoubted  though  mild  effect  upon  some  forms  of 
germ  life,  probably  equally  as  much  as  the  ultra-violet 
rays  of  the  solar  or  arc  light  spectrum.  It  is  therefore 
possible  in  the  treatment  of  superficial  conditions  and  in 
processes  in  the  cavities  of  the  body,  where  the  vacuum 
tubes  can  be  placed  in  close  relation  to  congested  or  in- 
fected tissues,  that  a  materially  beneficial  effect  will  be 
derived  from  their  action  upon  germ  life. 

From  the  above  observation  it  will  be  appreciated  that 
a  large  range  of  indications  exists  for  the  employment  of 
high  potential  modalities  in  the  treatment  of  all  types  of 
inflammation.  In  subsequent  chapters  details  will  be  given 
of  the  various  applications  to  special  conditions. 


CUAl'TEK   IV 

THE  HIGH  POTENTIAL  CURRENTS  IN  DISEASES  OF  THE  CIRCU- 
LATORY   SYSTEM 

Thkke  has  j)i'()l)alily  Ikhmi  iu>  advance  made  in  tlu'rajX'U- 
tics  which  \vill  c()ntril)utc  more  to  life  and  lonj^evity  than 
the  intnuliictiou  of  the  hi.uh  potential  currents  in  the 
treatment  of  art«'rial  sclerosis  and  its  causes.  That  such 
statements  are  not  reco<;nizcd  by  the  rank  and  tile  of  our 
profession  is  due  to  the  fact  that  the  use  of  electricity 
is  looked  upon  as  so  technical  that  the  average  man  is 
unwilling  to  investigate  the  methods  of  employing  it,  and 
for  this  reason  is  a])t  to  be  doubtful  of  its  efficiency. 
The  value  of  these  currents,  however,  has  been  well  estab- 
lisheil  and  the  eagerness  with  which  those  interested  are 
investigating  this  branch  of  medicine  is  encouraging. 

ITj'pertension  is  now  generally  acknowledgeil  as  the 
common  cause  of  sclerosis  of  the  middle  or  muscular  coats 
of  the  arteries  resulting  undoubtedly  from  the  fact  that 
a  muscle  maintained  in  a  state  of  tension  is  certain  to 
undergo  degeneration  owing  to  tiie  consifpK  iit  interfer- 
ence witli  the  cin  libit  it  HI  and  metabolism  under  tiiese  con- 
ditions. This  is  demonstrated  in  the  d<'generation  that 
takes  i>lace  in  long  muscles  which  are  for  a  long  time  in 
a  state  of  muscular  tension.  The  degeneration  is  first  of 
the  fatty  and  then  of  the  calcareous  transition,  in  which 
the  middle  coats  of  the  arteries  are  found  in  a<lvanced 
arterio-sclerosis.    Other  factors,  un<loiiiitedly,  as  ctuiditions 

159 


160  HIGH-POTENTIAL  CURRENTS 

of  malnutrition  favor  the  degenerative  process  in  the 
arteries.  Syphilis  has  also  been  shown  to  be  a  cause 
of  arterio-sclerosis.  The  important  study  therefore,  look- 
ing to  the  prevention  and  relief  of  arterio-sclerosis,  is  the 
management  or  prevention  of  hypertension. 

There  are  various  influences  which  under  normal  con- 
ditions affect  arterial  tension.  The  athlete,  as  the  young 
man  on  the  college  rowing  or  football  teams,  or  the  pro- 
fessional who  trains  to  perform  feats  of  strength  and 
agility,  maintains  his  muscular  condition  under  such  a 
degree  of  exercise,  that  the  heart's  force  must  be  increased 
to  perform  the  extra  work  put  upon  it  when  the  tension 
is  relatively  increased.  Then,  as  in  all  cases  of  hyper- 
tension there  is  a  coincident  hypertrophy  of  the  ventricles 
of  the  heart.  Under  extreme  exercise  the  tension  will 
increase  from  the  normal  110  or  120  mm.  to  130  or  140, 
or  even  150  at  which  after  hypertrophy  is  developed,  it 
will  remain  constant  unless  for  some  reason  the  abandon- 
ment of  active  pursuits  permits  a  gradual  lapse  in  the 
force  and  tone  of  the  heart  muscles,  due  to  a  gradual 
atrophy  with,  the  dilatation  persistent,  which  brings  the 
heart  into  a  state  of  incapacity  or  failing  compensation, 
when  the  blood  pressure  gradually  falls  far  below  the 
normal.  During  the  past  year  the  writer  has  noted  the 
tension  of  young  athletes  under  exercise  ranging  from 
10  to  30  mm.  above  normal;  and  one  young  man,  a 
young  college  student  who  had  for  three  years  worked 
upon  the  rowing  team  of  his  college,  after  three  weeks 
of  rest  exhibited  a  blood  pressure  of  150  mm.  In  another 
instance,  that  of  a  young  physician  who  had  previously 
been  an  athlete  on  a  college  team,  the  blood  pressure  was 
found  to  be  at  70  mm.  indicating  the  ultimate  sequelae 


DISEASES  OF  CIRCULATORY  SYSTEM       101 

of  the  injudicious  extremes  of  exercis<^  in  those,  who 
may  later  lead  sedentary  lives.  The  eauses  wiiich  induce 
hypert<>nsion  are:  (1)  the  rcsistdticc  in  titf  cirvnUitonj 
channels,  due  either  to  the  contraction  or  stenosis  of  the 
arterioles  or  conj]:esti(m  of  the  liver  and  kidneys  throu*:;h 
which  most  of  the  hlood  must  tlow ;  or  (2)  increase  in  the 
volume  or  quantity  of  circulating  fluid;  or  (3)  the  in- 
creased heart  force  induced  hy  the  demands  made  on  the 
system  during  exeiTise,  as  previously  shown;  or  from 
emotional  caust^s;  or  (4)  the  ingestion  of  alcohol irs  or 
other  drugs  which  produce  a  contraction  of  the  arterioles 
or  exei-t  an  increased  force  of  heart  action;  or  (5)  altered 
viscosity  of  the  blood. 

The  associated  pathological  arterial  conditions,  found 
present  with  hypertension,  are  probably  in  most  cases  the 
conse<iuence  and  not  the  cause  of  hypertension.  This  view 
is  now  generally  accepted,  and  though,  for  a  long  time, 
it  had  b<'<'n  the  opinion  of  tlie  profession  that  Bright's 
disease  was  the  cause  of  arteric^-sclei-osis,  at  present  it  is 
recogriiztnl  to  be  the  consequence.  hi  parenchymatous 
nephritis  and  cirrhosis  of  the  liver  however,  the  circula- 
tion is  ol)stnicte<l  l>y  the  engorgement  or  subsequent 
atrophy,  prmlucing  a  hypertension. 

In  parenchymatous  nephritis,  the  hypertension  is  com- 
pensat^>ry  and  does  not  lead  to  arterio-silerosis,  and  must 
under  no  circums-tauces  be  disturbed  by  lowering  of  blood 
pressure. 

The  study  of  hypertension  has  in  recent  years  been 
greatly  facilitated  by  the  invention  and  intnwluction  of 
practical  instruments  for  measurement,  the  most  accurate 
of  which  are  based  upon  the  principle  of  restraining  the 
circulation  of  the  forearm  by  a  liaiid  or  girdle,  made  to 


162  HIGH-POTENTIAL  CURRENTS 

constrict  the  soft  structures  of  the  arm;  the  pressure 
exerted  upon  the  blood  vessels  causing  the  pulse  to  dis- 
appear at  the  wrist.  The  pressure  required  to  overcome 
the  resistance  against  the  propelling  force  of  the  heart, 
when  constriction  is  made  by  an  inflated  rubber  sack 
beneath  the  constricting  band,  is  measured  by  the  height 
of  a  column  of  mercury  having  a  graduated  scale  and 
W'hich  is  subjected  under  the  arrangement  to  the  same 
pressure  that  is  exerted  to  restrain  the  circulation. 
When  pressure  is  released  from  the  circuit,  the  mercury 
column  falls  gradually,  when  at  a  certain  reading  the 
pulse  returns.  The  reading  at  the  instant  of  return  of 
a  full  normal  pulse  will  indicate  the  force  being  exerted 
by  the  heart ;  or  the  relative  arterial  tension. 

Several  types  of  sphygmomanometer  have  been  manu- 
factured to  meet  these  requirements  for  the  purpose  of 
measuring  arterial  tension,  most  of  which  are  constructed 
upon  the  principle  of  the  Riva-Rocci  as  described.  The 
measurement  is  based  upon  a  relative  pressure  exerted 
upon  the  column  of  mercury  in  circuit  with  the  same 
pressure  exerted  upon  the  arteries  of  the  patient  and  read 
in  millimeters  of  mercury.  There  can  be  no  question  as 
to  the  accuracy  of  those  of  the  type  described  which  are 
constructed  to  operate  with  a  mercury  column.  Another 
apparatus  which  is  calibrated  to  read  the  same  as  a 
merciir}-  column,  is  constructed  on  the  principle  of  the 
aneroid  barometer  and  is  very  sensitive  to  variations 
in  pressure.  Those  constructed  with  coiled  steel  springs 
are  not  apt  to  remain  accurate  as  under  various  climatic 
changes  with  humidity  the  iron  is  apt  to  become  rusted, 
and  the  springs  relaxed. 

The  introduction  of  these  instruments  of  precision  for 


DISEASES  OF  CIRCULATORY  SYSTEM      16:^ 

measuring  arterial  tension  lias  plaeed  the  profession  in 
a  position  to  judge  accurately  of  the  relative  conditions 
as  to  the  presence  of  hypertension  or  a  resulting  arterial 
sclerosis,  it  having  made  it  possible  to  make  practical 
studies  which  conld  not  be  made  by  reliance  upon  the 
sense  of  touch.  As  the  thermometer  is  definite  in  the 
measurement  of  temperatures,  so  is  the  sphygmomanom- 
eter in  the  measurement  of  arterial  pressure. 

The  normal  hjood  prcf^surc,  as  shown  experimentally  in 
observations  uix)n  a  large  number  of  patients  of  all  ages 
and  conditions,  seems  to  be  for  males  between  the  range 
of  105  and  120  mm.  and  for  females  from  90  to  110  mm., 
subject  to  relative  conditions  as  between  the  sexes — physi- 
cally strong  aud  athletic  women  often  showing  a  normal 
reading  as  high  as  120  mm.  wiiile  in  men  of  etYeminate 
structural  type  the  pressure  may  fall  as  low  as  100  mm. 
These  standards  are  based  upon  the  study  of  hundreds 
of  ca.ses  under  treatment  and  otherwise,  and  the  findings 
have  shown  that  in  a  very  large  number  of  adults  in  good 
health,  at  fifty  and  even  sixty  or  sixty-five  years  of  age, 
the  blood  pressure  does  not  exceed  120  ram.  This  occurs 
in  individuals  usually  of  a  careful  hai)it  of  life  wlio  have 
eaten  mcxlerate  quantities  of  food,  and  avoided  consump- 
tion of  alcohol  aud  stimulating  foods  to  excess.  On  the 
other  hand,  it  is  often  found  that  in  young  adults  par- 
ticularly those  wh(>  are  inclined  to  consume  food  without 
regard  to  exercise,  that  the  blood  pressure  may  be  even 
as  high  as  150  to  170  mm.  Tlie  average  adult  at  forty-five 
to  fifty  years  of  age,  will  show  an  arterial  pressure  rang- 
ing from  140  to  100  mm.,  but  for  no  reason  should  such 
tension  be  called  normal  at  any  age.  In  most  cases  when 
the  blood  pressure  exceeds  normal,  it  may  be  accounted 


164  HIGH-POTENTIAL  CURRENTS 

for  in  the  habits  of  the  life  of  the  individual,  when  his 
health  is  otherwise  objectively  unimpaired,  but  conditions 
have  arisen  which  induce  hypertension  without  the  pres- 
ence of  other  symptoms. 

The  causes  of  hypertension  are  of  natural  interest  in 
connection  with  the  investigation  of  methods  of  treatment. 

It  seems  now  to  have  been  demonstrated  beyond  any 
question  that  conditions  within  the  alimentary  canal  have 
more  to  do  with  the  establishment  of  hypertension  than 
other  affections.  The  common  habit  in  a  country  and 
with  a  people,  who  have  an  abundance  of  good  food  and 
drink  provided  several  times  daily,  is  to  overeat.  Over 
indulgence  and  excessive  eating,  particularly  of  foods  rich 
in  proteids,  a«  meat,  are  most  objectionable.  It  cannot 
be  stated  however  that  carbohydrates  in  connection  with 
exces-sive  feeding  do  not  also  play  a  role  in  auto-intoxica- 
tion processes. 

An  excessive  quantity  of  food,  improperly  masticated  or 
otherwise,  constitutes  the  chief  source  of  intestinal  fer- 
mentation, affording  as  it  does  from  all  foods  that  are 
undigested  and  unassimilated  culture  media  for  the  growth 
of  bacteria  in  the  intestinal  canal  particularly  in  the  colon. 
That  bacteria  and  their  toxine  products  under  such  con- 
ditions are  a  prolific  source  of  irritation,  in  the  blood, 
acting  either  as  direct  irritants  to  the  muscular  coats  of 
the  arteries,  or  affecting  the  tension  through  some  action 
directly  upon  the  vaso-motor  centers,  possibly  by  affecting 
the  adrenal  system,  seems  to  be  established. 

Regulation  of  exercise  to  the  food  consumed  is  another 
factor  upon  which  depends  to  a  large  degree  the  regula- 
tion of  metabolism,  leading  to  conditions  which  induce 
hypertension.    For  in  individuals  who  live  sedentary  lives, 


DISEASES  OF  CIRCULATORY  SYSTEM      165 

and  eat  iiimuMk'rately,  the  ilisp(>sitioii  to  hypertension  is 
marked,  wlien'as,  in  those  who  lead  laliorions  pnrsnits,  the 
consumption  of  lar<i(>  (luantities  of  food  may  not  induce 
hypertension.  The  demands  of  the  sysU'm  and  activity 
of  the  absorbents  under  such  conditions  siH?ming  to  rol) 
the  intestinal  germs  of  the  nutrition  necessary  to  their 
growth. 

It  is,  therefore,  of  t^he  utmost  importance  in  cases  in 
which  hypertension  is  diagnosed,  to  give  attention  to  all 
imp<irtant  features  of  habit,  in  order  that  the  causes  may 
be  eliminated.  A  diminished  quantity  of  food  is  indicated 
in  most  cases.  The  correction  of  diet  by  the  limitation 
of  proteid,  particularly  animal  proteid,  in  cases  of  marked 
hvixM'tension,  and  the  institution  of  regulated  exercise 
in  tlKKso  whose  liabits  are  seilentary,  is  indicated.  Walk- 
ing, golf,  tennis,  hand  ball,  or  other  active  gymnastic 
exercise  should  be  instituted  as  a  routine  regime  with 
all  patients  in  whom  the  blood  pressure  is  rapidly  lowered 
below  140  mm.  even  though  the  initial  reading  had  l)een 
al>ove  200  mm.  It  is  possible  in  many  of  these  cases  after 
a  short  time  to  altogether  control  the  conditions  by  the 
regulation  of  exercise  and  diet;  but  not  at  the  outset. 

The  electrical  treatment  of  hypertension  is  one  of  the 
m<>st  important  discoveries  in  the  management  of  these 
caM'.'^.  It  far  surpasses  tiie  empl(>yment  of  any  drug  medi- 
cation or  the  Xauheim  baths,  and  when  employed  in  con- 
nection with  regulation  of  the  habits  of  diet  and  exercise, 
as  pre\iously  suggested,  it  is  possible  to  lower  arterial 
tension  very  materially,  and  to  maintain  it  at  an  entirely 
Siife  range,  even  in  a4ivaneed  cases  of  arterio-selerosis.  In 
considering  the  management  of  these  cases,  the  writer  has 
adopted  a  classification  based  upon  th<'  patient's  response 


166  HIGH-POTENTIAL  CURRENTS 

to  treatment,  finding  no  other  in  the  literature.  It  is  a 
well  established  fact  in  the  experience  of  all  who  have 
made  considerable  use  of  the  auto-condensation  and  auto- 
conduction  methods,  that  with  twelve  to  fifteen  minute 
seances,  employing  approximately  500  milliamperes  as 
measured  by  a  hot  wire  meter,  it  is  possible  to  lower  the 
blood  pressure  from  ten  to  thirty  millimeters  of  mercury, 
except  the  advanced  cases  of  arterio-sclerosis.  The  author 
has  had  under  observation  eight  cases  in  which  there  would 
be  a  fall  of  from  three  to  five  mm.  but  under  daily  treat- 
ment no  progress  was  made,  the  tension  not  falling  as  it 
does  in  other  cases. 

These  resisting  cases,  occurring  as  they  do  in  old  people, 
demonstrate  when  treated  consecutively  as  they  have  been 
by  the  writer  for  weeks,  that  the  action  of  the  electric  cur- 
rents in  no  tvise  affects  the  compensation  of  the  heart 
muscles,  or  in  other  words,  they  do  not  depress  the  heart. 
This  is  a  very  important  observation,  and  one  that  is  cer- 
tain to  be  carefully  considered  by  those  who  may  con- 
template the  employment  of  the  method.  The  effects  of 
the  treatment  on  the  contrary  are  beneficial  even  with 
the  resisting  cases,  due,  probably  to  the  influence  upon 
general  metabolism;  promoting  as  it  does  elimination  of 
the  products  of  metabolism,  which  are  liable  to  accumulate 
in  old  people  the  subjects  of  advanced  arterio-sclerosis. 

The  classification  based  upon  results  of  treatment  which 
the  writer  adopted  in  a  previous  paper  on  the  subject* 
seems  to  give  a  practical  index  as  to  the  prognosis,  to  be 
determined  from  the  history  or  results  of  treatment  for 
a  week  or  two,  it  being  effective  in  cases  in  varying  de- 


*  Treatment  of  Arteriosclerosis  and  Hypertension.     Journal  of  Advanced 
Therapeutics  for  June,  1909. 


DISEASES  OF  CIRCULATORY  SYSTEM      167 

grees  (lepcMidiiifx  upon  tlic  prohahle  extent  of  the  sclerotic 
piH)cess. 

Claims  I.  ///  tin-  >i(/i'(l  and  feeble,  with  loweriHl  nutrition 
or  resistance,  wliicli  lias  arisen  from  some  impairment  of 
digestion,  or  an  intervening  nei)liritis,  or  other  cause,  the 
tension  may  be  low  while  the  sclerosis  is  far  advanced 
owing  to  a  want  of  compensation  of  the  feeble  heart 
muscles.  Low  sphygmomanometric  readings  with  marked 
sclerosis  of  the  arteries,  is  an  indication  of  failing  com- 
pensation, which  may  also  l>e  present  with  valvular  lesions, 
or  in  cases  in  which  dilatiition  is  pi^esent  without  hyper- 
trophy (see  Class  VI).  In  the  investigation  of  arterial 
tension,  the  presence  or  absence  of  heart  compensation 
must  always  be  considered. 

Class  II.  General  arterio-selerosis  icith  persistent  high 
arterial  tension,  ranging  from  200  to  240  mm.  or  even 
more,  occurs  in  those  of  advanced  age,  and  may  be  so 
resistant  to  administrations  of  auto-condensation  Avhich 
uniformly  lower  arterial  tension,  when  above  normal  in 
other  cas€\s,  that  no  measure  of  relief  may  be  afiforded. 
In  these  cases  it  is  probable  that  the  entire  arterial  sys- 
tem, including  the  small  arteries,  are  ta  a  marked  degree 
sclerosed.  In  these  cases  the  imjxMiding  stniuelae  cannot 
be  averted,  excei)t  by  an  even  life  free  from  excitement, 
and  the  employment  of  a  non-stimulating  diet,  by  which 
life  may  be  prolonged. 

Cla.ss  III.  Arteriosclerosis  iti  most  patients  at  ages  from 
sixty  to  seventy  years  may  often  at  first  seem  to  resist 
measures  which  atTect  liigh  arterial  tension,  without  pro- 
ducing cardiac  depression,  but  yield  linally  under  treat- 
ment and  are  reduced  to  a  degree  of  hypertension  which 
will  avert   apoplexy  witii  corresponding  improvement  in 


168  HIGH-POTENTIAL  CURRENTS 

general  health.  In  these  cases  in  which  the  reading  at 
the  onset  is  often  more  than  200  millimeters  of  mercury, 
the  tension  may  be  scaled  down  in  the  course  of  a  month 
or  six  weeks  by  daily  or  alternate  day  treatment  to  165 
to  160  mm.  or  even  in  some  cases  as  low  as  140  mm., 
at  which  the  tension  may  be  maintained  by  regulation  of 
diet  and  occasional  treatment.  This  class  of  cases,  should 
not  be  directed  to  take  active,  but  moderate  exercise. 
Patients  in  this  class  will  usually  be  of  advanced  arterio- 
sclerosis with  a  marked  degree  of  cardiac  hypertrophy, 
but  judging  from  clinical  results,  it  is  probable  that  some 
of  the  vessels  still  respond  to  the  high  potential  currents 
which  vary  vaso-motor  conditions  without  producing  heart 
depression.  It  might  be  possible  in  these  cases  if  daily 
treatments  were  administered  to  bring  the  blood  pressure 
down  to  normal — 120  mm. — but  it  would  be  imprudent  to 
alter  the  conditions  of  relation  between  cardiac  hyper- 
trophy and  the  work  demanded  in  these  cases  to  such  a 
marked  degree.  On  the  other  hand  the  effort  here  should 
be  directed  to  relieving  the  heart  of  excessive  labor,  and 
at  the  same  time  reduce  to  a  minimum  the  dangers  of 
apoplexy  and  nephritis.  It  is  the  author's  opinion  that 
by  judicious  watching  and  management,  these  cases  may 
be  kept  at  a  status  quo  for  an  indefinite  period,  probably 
five  to  ten  years,  or  even  longer  in  the  more  favorable 
cases;  this  seems  to  have  been  demonstrated  in  some  cases. 
On  general  principles  it  is  best  to  maintain  the  arterial 
tension  in  these  cases  between  140  and  170  mm.  with  a 
general  possible  average  of  150  t-o  155  and  without  danger 
in  case  of  an  occasional  maximum  of  180  mm. 

Class  IV.     These    cases    include   those    of    advancing 
arterio-sclerosis  in  mature  adults  generally  at  ages  rang- 


DISEASES  OF  CIRCULATORY  SYSTEM      1G9 

in<:j  from  thirty-five  to  sixty,  in  whicli  the  tension  may  have 
scaled  to  from  150  to  200  mm.,  associated  or  not  with  a 
commencing  interstitial  nephritis.  Nephritis  is  often  not 
present  in  cases  having  an  arterial  tension  of  from  200 
to  250  mm.  Patients  in  this  class  after  twelve  to  fifteen 
minutes  of  auto-coudensiition  employing  400  to  500  milli- 
amperes  will  show  a  marked  fall  in  arterial  tension  averag- 
ing ten  to  fifteen  mm.  and  with  frequent  treatments  given 
in  connection  with  regulation  of  diet  and  exercise  will 
rapidly  be  reduced  to  or  near  normal.  In  these  earlier 
cases,  the  cardiac  hypertrophy  is  apt  to  be  marked,  but 
is  rarely  complicated  by  dilatation,  and  the  tension  may 
be  safely  lowered  to  the  high  normal — 120  mm.  and  main- 
tained there  without  danger  of  producing  any  subsequent 
failure  of  cardiac  compensation,  but  greatly  to  the  relief 
of  the  patient. 

If  nephritis  with  albumen  and  casts  is  present  they 
usually  disappear  from  the  urine  after  treatment  for  a 
few  weeks,  and  a  general  sense  of  well  being  replaces  the 
previous  feeling  of  weight  and  tension.  With  nephritis  it 
is  generally  advisable  to  also  employ  the  static  wave  cur- 
rent daily,  for  the  pui'i)ose  of  relieving  the  congestion. 
An  electrode  which  will  cover  the  region  of  the  kidney 
should  l>e  employed  for  twenty  minutes  with  a  six  to  ten 
inch  spark-gap  prece<ling  the  daily  auto-condensation 
treatments.  There  is  probably  no  more  eflficient  means  of 
overcoming  an  interstitial  or  parenchymatous  nephritis 
than  the  application  of  the  s-tatic  wave  current  in  this 
manner.  It  will  be  found  however,  that  with  the  com- 
bined US4'  of  the  wave  ciirrrnt  with  tiir  high  frequency 
current  in  chronic  interstitial  nephritis,  the  reduction  of 


170  HIGH-POTENTIAL  CURRENTS 

the  blood  pressure  will  be  at  first  less  marked,  owing  to 
the  counter  action  of  the  two  currents. 

Class  V.  This  class  is  characterized  by  a  condition  of 
hypertension  found  usually  in  adults  at  from  twenty-five 
to  sixty-five  years  of  age,  in  which  the  sphygmomanometer 
indicates  the  presence  of  a  moderate  degree  of  hyperten- 
sion, ranging  from  130  to  145  mm.,  but  who  respond 
promptly  to  d'Arsonvalization  with  a  fall  of  arterial  ten- 
sion. In  this  class  are  represented  the  cases  which  are 
as  a  rule  incidentally  found  when  under  treatment  for 
some  other  condition,  or  when  examination  is  made  for 
life  insurance.  These  patients  have  not  generally  devel- 
oped any  atheromatous  or  sclerotic  condition  of  the  arter- 
ies, but  will  if  hypertension  is  allowed  to  persist  and 
increase  as  it  is  certain  to  if  neglected.  In  these  cases, 
the  patient  may  be  rendered  relatively  normal,  and  with 
the  proper  regulation  of  the  diet  and  exercise,  present  an 
uniformly  favorable  prognosis.  There  is  probably  no  con- 
dition so  insidious  and  unobserved  as  the  steady  inroads 
leading  to  arterio-sclerosis,  and  no  field  to  which  the 
physician's  timel3'  attention  can  afford  more  service  to 
hmnanity;  by  correcting  the  conditions  which  develop 
arterial  degeneration ;  thereby  saving  from  pending  dis- 
aster the  individuals  included  in  this  class  of  cases. 

Class  VI.  Adults  who  have  led  very  active  athletic 
pursuits,  comprise  this  class.  They  may  have  developed 
cardiac  hypertrophy  from  over  training  on  a  college  team, 
or  as  athletes,  boxers,  or  others  who  have  been  for  long 
periods  under  severe  training  or  physical  exertion;  and 
have  developed  a  muscular  system  which  has  made  great 
demand  upon  the  cardiac  muscles.  Under  such  condi- 
tions the  demands  upon  the  circulation  are  so  great  that 


DIS^EASES  OF  CIRCULATORY  SYSTEM       171 

the  cardiac  livpcrtropliy  is  associated  with  dilatation. 
Probably  no  class  of  cardiac  affection  has  received  less 
consideration  than  this.  The  recoi,Miition  of  the  eiTor  of 
excessive  exerci.se  and  its  conse<jnences  are  not  often 
enouji^h  recojjnized  by  those  in  charp:e  of  colleiie  atliletics. 

The  nianaj,'enient  of  this  class  is  prophylactic,  looking 
to  the  consequences  after  discontinuance  of  active  pursuit 
and  training,  when  there  is  certain  to  follow  an  atrophy 
of  the  cardiac  muscles  and  jx^rsistence  of  the  dilatation, 
that  has  eoincidently  occurred,  resulting  in  the  serious 
condition  of  cardiac  dilatation  without  hypertrophy.  In 
these  patients  as  the  atrophy  advances,  the  blood.  pres.«?ure 
falls  and  the  patient  may  ])ass  into  a  hopeless  condition 
or  in  the  le.ss  severe  cases,  exist  with  sutticient  cardiac 
compen.sation  to  enable  him  to  follow  a  sedentary  life,  but 
always  with  dyspnoea  on  exertion,  and  an  imixniding  dan- 
ger of  ultimate  collapse. 

Class  VII.  Cases  of  compensatory  hypertension  due  to 
obstructing  parencliymatous  ne])hritis  or  cirrhosis  of  the 
liver,  or  other  conditions  demanding  compensatory  ten- 
sion, which  may  be  present  with  or  without  arterio- 
sclerosis, usually  occur  as  a  temporary  condition.  In  this 
classification  we  have  included  a  variety  of  conditions  in 
whicli  the  .study  ami  management  of  h.^'pertension  and  the 
allied  aU'ections,  is  of  much  imi)ortance  to  the  practitioner, 
and  of  great  moment  to  the  patient.  In  these  eases  there 
are  three  significant  indications:  (1)  to  overcome  as  soon 
as  possible  the  condition  of  cong(*stion,  particularly  a.s 
present  in  the  <li.sea.ses  of  the  liver  and  kidneys  referred 
to;  (2)  to  impi-ove  metabolism  and  promote  elimination 
by  other  channels,  particularly  to  assist  tlic  elimination 
by  perspiration  of  the  waste  products  not  eliminated  by 


172  HIGH-POTENTIAL  CURRENTS 

the  impaired  kidnejs;  and  (3)  to  maintain  a  high  arterial 
tension  when  it  is  compensatory. 

There  is  no  measure  which  acts  with  such  potency  and 
certainty  in  relieving  congestion  of  a  cirrhotic  liver  or  of 
an  inflamed  kidney  as  the  static  wave  current.  In  the 
hypertrophic  stage  of  cirrhosis  of  the  liver  it  is  possible 
by  applying  a  large  metal  electrode  over  the  distended 
liver  and  using  a  spark-gap  long  enough  to  produce  de- 
cided pulsation  and  tissue  contraction  throughout  its  sub- 
stance to  rapidly  reduce  the  infiltration.  In  the  writer's 
experience  in  two  cases  livers  of  this  sort  were  reduced 
to  near  the  rib  line,  and  others  very  materially  reduced 
with  a  relative  improvement  in  the  physical  condition  of 
the  patient.  This  same  effect  has  been  obtained  by  others 
in  reducing  enlarged  spleens  due  to  malarial  infection. 

In  parenchymatous  nephritis  a  metallic  electrode  six 
by  eight  inches  in  size  is  placed  over  the  region  of  both 
kidneys,  which  situated  as  they  are  just  beneath  the 
muscles  of  the  back,  are  readily  affected  by  the  wave  cur- 
rent, when  employed  with  a  spark-gap  varying  from  six 
to  ten  inches,  depending  upon  the  thickness  of  fat  over- 
lying the  muscles,  or  the  character  of  the  muscular  struc- 
tures themselves.  A  fortunate' coincidence  exists  in  that 
the  wave  current  does  not  materially  affect  to  lower 
arterial  tension,  and  may  be  applied  in  these  cases  with 
sufficient  energy  to  relieve  the  infiltration  without  lower- 
ing the  compensatory  hypertension. 

The  effect  upon  general  metabolism  in  these  cases  is 
to  increase  the  resistance  of  the  cell  by  improving  peri- 
pheral nutrition  and  to  promote  the  elimination  of  urea 
through  the  skin,  thereby  lessening  in  parenchymatous 
nephritis  the  danger  of  uremic  poisoning.     For  this  pur- 


DISEASES  OF  (CIRCULATORY  SYSTEM      173 

pose  the  electric  liyht  hatlis  in  wliicli  radiant  li;i;lit  and 
beat  may  he  administered  witli  the  patient  reeliniii«;,  are 
prohahlv  of  tirst  iniinirtancc,  i-onihinini::  as  thcv  (h)  th»' 
henetieial  ctreets  of  lii;iit  and  the  important  ett'ects  of 
heat.  TJic  body  dry  hot  air  bath,  in  lieu  of  the  properly 
constriieted  light  hath,  would  serve  very  niueh  the  same 
purpi>se  in  stimulating  perspiratitMi  and  (diminat  ion.  Roth 
of  the  last  named  measures  also  stimulate  the  deep  spinal 
centers  of  the  heart  and  re.spiration  to  greater  energy  and 
coineideutly  relieve  them  from  the  toxic  influences  of  the 
poisonous  waste  products  otherwise  retained  on  account 
of  the  iniitaired  function  of  the  kidneys.  The  static  wave 
current  as  ai)i)lied  for  relieving  congestion  elsewhere  also 
coineideutly  facilitates  general  metaholism  and  elimina- 
tion. These  measures  are  congeners,  cooperating  to  relii-ve 
the  system  of  the  jwisons  which  might  otherwise  over- 
whelm the  organism. 

In  order  to  timiiitain  the  compensatory  high  arterial 
tensio)i  which  is  present,  in  these  ohstructed  conditions, 
the  auto-condcnsatio)}  nirthod  should  )icrer  he  employed 
Irst  a  fatal  n  hij-alioit  of  ttir  arlii'irs  loirer  the  blood  ten- 
sion, irJiich  is  net-cssar//  to  force  tlw  Jilood  throiif/h  the  con- 
gested kidney.  To  lower  arterial  tension  in  parenchy- 
matous nephritis  might  he  fatal.  It  is  then  a  matter  of 
grave  con.sideratiiui  to  avoid  an  error  so  apt  to  inadver- 
tently oiiur,  of  lowering  arterial  tension  in  these  j)atient.s. 
It  is  a  fortunate  coincidence  that  the  static  wave  current 
doi'S  not  atTect  hhxKl  pressure  in  these  ca.ses;  hut  on  the 
contrary  acts  to  relieve  the  infiltration  which  cau.ses  the 
ohstniction.  Light  baths,  while  inducing  to  a  degi*ee  super- 
ficial arterial  relaxation,  do  not  seriously  impair  the  con- 
ditii>n  of  conipen.satory  tension;  an<l  are  therefore  in  no 


174  HIGH-POTENTIAL  CURRENTS 

wise  contraindicated  but  very  imx>ortant  in  the  treatment 
of  parenchymatous  nephritis. 

The  treatment  of  hypertension,  as  will  be  inferred  from 
the  preceding  paragraphs,  must  judiciously  employ  vari- 
ous measures  to  meet  the  varying  indications.  The  pro- 
cedures indicated  for  the  control  or  coiTection  of  hyper- 
tension may  be  divided  into  ( 1 )  those  which  act  upon  the 
neuro-muscular  mechanism,  as  the  d'Ansonval,  high  fre- 
quency and  static  wave  currents,  radiant  light  and  heat, 
hot  baths,  and  carbonic  acid  baths  (the  least  important) ; 
(2)  those  which  increase  general  metabolism,  including 
the  high  potential  currents,  radiant  light  and  heat,  exer- 
cise and  the  employment  of  baths  of  alternating  heat  and 
cold  with  those  who  respond;  and  (3)  those  which  regu- 
late nutrition  eliminating  from  the  diet  foods,  which  un- 
assimilated  or  undigested,  furnish  culture  media  for  the 
development  of  bacteria;  the  toxines  arising  from  which 
are  the  principle  factor  in  causing  hypertension. 

The  diet  regime  employed  by  the  Avriter  consists  in  the 
avoidance  of  red  meats,  and  at  the  onset  all  fish  and  fowl 
as  well,  and  in  advanced  cases  the  avoidance  of  all  animal 
foods  as  a  permanent  diet  regime,  the  abstinence  from  all 
alcoholic  drinks,  and  the  institution  to  a  considerable  de- 
gree of  a  milk  diet.  The  Metclinikoff  method  of  employ- 
ing milk  prepared  by  the  use  of  lactic  acid  ferments,  meets 
the  indications  in  some  cases,  but  a  larger  experience 
shows  that  in  many  cases  it  proves  decidedly  objectionable. 

Probably  the  principle  of  greatest  importance  in  the 
dietetic  regime  is  the  reduction  of  the  quantity  of  food 
taken.  If  these  patients  are  put  upon  half  the  rations 
they  have  been  in  the  habit  of  consuming,  there  are  but 
few  of  them  who  would  lose  a  pound  of  weight,  indicating 


DIS-EASES  OF  CIRCULATORY  SYSTEM      175 

tbo  amount  of  unabsor!H><l  paluiluin  rcnialniiij;  t-o  dovelop 
an  intestinal  tlora. 

A  diyninifihcfl  quantity  of  food,  together  with  the  rejec- 
tion of  animal  itinirid,  constitutes  the  most  imi>ortant 
features  of  the  average  diet  regime;  together  with  the 
thorough  mastication  of  food. 

To  />rt>'(rre  a  condition  of  hvnltJi  with  normal  blood 
pressure,  as  a  prophylactic  measure,  the  diet  must  be 
regulated  to  the  exercise  or  the  individual  pays  the  penalty. 
When  hypertension  is  already  present,  exercise  is  indi- 
cated in  all  conditions,  except  those  included  in  Class<*s 
I  and  II  and  VII.  Exercise  is  imperatively  indicated  when: 
the  blood  pressure  has  been  reduced  to  150  or  160  mm. 

Exercise  must  he  regulated  to  the  arterial  condition, 
and  may  be  necessiirily  very  moderate  in  tJiose  of  Class 
III  in  whom  an  exti*eme  would  precipitate  too  great  a  rise 
in  arterial  tension.  In  Classes  IV  and  V  the  degree  of 
hypertension  present  indicates  a  rapid  tendency  to  arterio- 
sclerosis, which  in  Class  IV  may  have  developed  to  a  well 
niai'ked  dogrei';  whereas  in  Class  VI  exercise  is  indicated 
for  the  puiijose  of  maintaining  the  cardiac  hypertrophy; 
for  if  the  heart  is  allowed  to  atrophy  the  presence  of  dila- 
tation without  hypertrophy  would  become  a  serious  im- 
p<Hliment,  endangering  the  comfort  if  not  the  life  of  the 
individual. 

The  clrrtricai  treatment  of  hyperten-sion,  except  as  con- 
sidered in  the  cases  of  compensatory  hypertrophy,  in  which 
modalities,  which  lower  blood  pressure  are  contraindicat(^d, 
is  the  mOvSt.  valuable  meth<Kl  of  regulation  yet  discovered. 
It  is  possible  in  all  except  Class<'s  I  and  II  to  lower 
arterial  tension  at  each  administration  (►f  from  twelve 
to  fifteen  minutes  to  a  marked  d<'gree — from  ten  to  twenty, 


176  HIGH-POTENTIAL  CURRENTS 

or  even  tliirtj  mm. — by  the  auto-condensation  method  em- 
ploying 400  to  500  milliamperes  as  shown  by  the  hot  wire 
meter.  This  current  undoubtedly  relaxes  or  dilates  the 
arterioles.  The  modus  operandi  of  the  current  in  influ- 
encing such  dilatation  is  difficult  to  demonstrate  or  ex- 
plain. It  is  possibly  due  to  the  thermic  action  of  the 
current.  The  body  heat  throughout  the  whole  substance 
of  the  individual  is  not  comparable  to  external  applica- 
tions of  heat,  but  to  the  energetic  induction  of  metabolism 
and  heat  production  throughout  the  organism,  which  is 
manifested  by  a  general  glow  or  feeling  of  warmth.  It 
is  either  this  effect,  or  the  effect  of  high  potential  cur- 
rents upon  the  muscular  structures  of  the  arteries,  or  upon 
the  nervous  mechanism  which  controls  the  vaso-motor 
tension. 

The  effect  of  d'Arsonvalization  is  pronowiced,  uniformly 
lowering  the  arterial  tension  when  the  current  is  admin- 
istered to  an  individual  in  the  classes  under  consideration, 
whereas  when  the  blood  pressure  is  normal,  there  is  very 
little  if  any  change  from  the  usual  administration. 

The  heart  is  not  depressed  either  by  the  method  of  auto- 
condensation  or  auto-conduction.  This  may  be  easily 
demonstrated  as  it  has  been  by  the  writer  in  numerous 
instances,  when  administered  on  consecutive  days  to  aged 
patients  of  Class  II  who  do  not  respond  to  treatment  with 
a  reduction  of  blood  pressure  even  when  administered 
daily  for  months.  When  administered  to  these  patients 
there  is  a  sense  of  relief  from  dizziness  with  no  lowering 
of  blood  pressure,  showing  conclusively  that  there  is  no 
interference  with  compensation.  Patients  on  the  other 
hand  who  are  subjects  of  high    arterial    tension    feel    a 


DIS.EASES  OF  CIKCULATOKY  SYSTEM       177 

marked  rolu-f  with  a  s(misc  of  lightness  following  the  ad- 
ministration of  d'Arsonvalization. 

The  methmis  of  ciiiitlovin^  a  (rArsonval  cnrnMit  for  re- 
lieving arterial  hypfrtcnsion  as  illustraUMi  in  Figs.  17 
and  45  are  the  methods  hy  anto-conduetion  and  auto-eon- 
densation,  both  practieal  and  etfeetive  measures. 

Tin  auto-condcnsati<ni  method  possesses  advantages  over 
the  method  <>f  auto-eondurtion,   })articularly   in    the  con- 


FlG.   45.      Arrangement   for  Auto-Conduction. 
The  two  end-i  of  the  solenoid  may  he  connected  to  the  d'Arsonval   termi- 
nals of  apparatus,  or  they  can  he  connected  directlj*  across  the  outer 
coatings  of  the  l^yden  jars  and  tlie  Oudin  solenoid  disconnect«Ml. 

venience  of  administration  upon  a  conch  and  the  regu- 
lation of  dosiige  with  the  hot  wire  meter,  by  which  means 
it  is  possible  to  judge  with  the  same  apparatus  at  h'ast, 
of  the  relative  effects  o{  current  dosage  As  stated  else- 
where, it  is  a  well-established  fact  that  the  variations  in 
the  measuH'  of  currents  by  the  hot  wire  meter,  from  dif- 
ferent types  of  apparatus  are  considerable,  which  l(»ads  to 
confusion  as  to  the  relative  dosage  to  employ  with  different 
types  of  apparatus. 


178  HIGH-POTENTIAL  CURRENTS 

The  frequency  factor  is  one  that  must  be  understcKxi  as 
increasing  the  heat  production  without  an  actual  increase 
in  current  flow.  The  readings  of  the  milliamperemeter 
vary  with  the  frequency  or  periodicity  without  variations 
in  current  strength.  The  writer  is  in  the  habit  of  testing 
the  relative  volume  of  discharge  by  holding  the  flat  sur- 
face between  the  first  and  second  joints  of  a  finger  against 
the  hand  of  the  patient,  when  if  the  discharge  is  of  a 
satisfactory  character,  for  affecting  high  arterial  tension, 
it  will  produce  a  hot  discharge  about  the  size  of  a  dime 
and  -vsithout  a  sharp  stinging  sensation.  In  some  of  the 
types  of  Tesla  apparatus  the  same  discharge  in  making 
this  test  produces  a  very  severe  burning  sensation.  The 
"writer  has  compared  apparatus  in  which  the  milliampere- 
meter has  read  in  some  instances  from  1200  to  1500  mil- 
liamperes  with  far  less  discharge,  though  of  the  character 
described,  than  from  other  types  of  apparatus  which 
register  from  400  to  500  milliamperes. 

Regardless  of  meter  readings,  the  test  of  efficiency  of  any 
apparatus  u>ill  depend  upon  the  average  fall  of  hlood  pres- 
sure in  millimeters  of  mercury.  A  properly  constituted 
apparatus  and  arrangement  produces  an  average  fall  of 
from  ten  to  thirty  millimeters  after  each  administration. 
Patients  who  are  treated  in  this  manner  under  favorable 
conditions  of  environment  and  habit  of  diet,  mark  a  gain 
of  from  three  to  ten  millimeters  from  day  to  day  when 
the  current  is  administered  daily,  which  is  at  the  ooitset 
necessary  in  cases  in  w^hich  the  tension  has  been  high 
until  such  time  as  the  tension  is  reduced  to  the  desired 
reading,  at  which  it  is  intended  to  attempt  to  hold  the 
blood  pressure,  when  it  is  possible  to  give  the  treatments 
on  alternate  days,  or  in  many  cases  le»s  frequently,  until 


DISEASES  OF  CIRCULATORY  SYSTEM      179 

the  reg'ulation  of  the  diet  and  exercise  of  the  patient  Ls 
such  thiit  the  tensfion  shows  k\ss  tendency  to  rise,  after 
which  the  patient  sliould  report  at  first  weekly,  and  later 
monthly,  in  order  that  by  joint  observation  the  conditions 
may  be  rej^iilatiMl. 

Every  patient  who  has  onee  developed  a  hi/pcrtension 
eonsidtrably  above  normal  should  have  observations  made 
from  time  to  time  in  order  to  avoid  a  repetition  of  the 
tendency  to  re-establishment  of  a  high  pressure,  and  the 
more  pwnounced  castas  should  keep  themselves  constantly 
under  obseiTation  in  order  to  keep  arrested  the  tendency 
which  will  be  constantly  present  of  the  arterial  tension  to 
again  become  high. 

The  method  by  auto-conduction  in  which  the  patient  is 
seated  within  the  solenoid,  receiving  and  conducting  the 
lines  of  electrical  energy  passing  inductively  across  the 
field,  feels  a  perceptible  glow  of  warmth.  Under  these 
influences  the  thermic  action  of  the  current  is  extended, 
and  the  blood  pressure  lowered.  Here  again  the  indication 
is  that  the  lowering  of  blood  pres.sure  is  to  a  degree  due 
to  the  thermic  action  of  the  current.  The  same  principle 
is  employed  here,  as  in  heating  metals  to  a  great  heat 
when  placed  within  small  solenoids  when  larger  ampere 
currents  are  passing.  There  is  no  doubt  that  the  action 
of  this  current  is  fairly  uniform  upon  all  parts  of  the  body 
of  the  patient;  and  it  may  i)ossess  an  advantag(^  in  this 
respect  over  the  auto-condensa til »n  inctlKMJ  in  that  the  con- 
denser effects,  as  shown  in  Fig.  17,  cause  the  greater  con- 
densiitiim  <if  the  current  to  pass  through  the  tissues  nearest 
the  comlenser  plate  beneath  tiie  cushion.  Tiie  ellect  how- 
ever upon  blood  pressure,  as  shown  by  recent  observations, 
is  variable  by  this  method,  depending  ui>on  the  construe- 


180  HIGH-POTENTIAL  CURRENTS 

tion  of  the  solenoid.  Those  of  many  turns  of  fine  wire 
tend  to  raise  instead  of  lowering  arterial  tension. 

That  the  nutritional  effect  of  auto-conduction  is  remark- 
able, was  demonstrated  by  Dr.  Herdman  of  Ann  Arbor 
by  placing  a  number  of  young  rabbits  of  a  litter  for 
some  hours  daily  within  a  solenoid  they  being  kept  other- 
wise under  the  same  conditions  as  the  control  rabbits, 
Wihich  were  not  so  treated.  The  former  made  a  more 
thrifty  growth  and  gained  in  weight  and  size  over  the 
controls. 

A  meter  for  shoidng  the  relative  strength  of  current 
passing  through  the  patient  taking  auto-conduction  has 
been  designed  by  Denoyes  of  France. 

Another  method  of  employing  auto-conduction  may  be 
employed  with  the  static  machine.  The  patient  is  placed 
upon  a  chair  upon  the  insulated  platform  and  put  in  a 
reclining  position  and  a  half  cage  is  draw^n  down  just  far 
enough  away  from  every  part  of  the  patient  not  to  permit 
sparks  to  pass  from  his  body  to  the  grounded  cage.  A 
connection  is  made  to  the  platform  with  the  shepherd's 
crook,  or  a  chain  or  rod  connecting  the  platform  with  the 
positive  side  of  the  machine.  The  negative  side  is  then 
grounded,  and  a  spark  two  inches  in  length  is  permitted 
to  discharge  between  the  pole  pieces,  the  machine  running 
at  a  rapid  rate  of  speed.  This  method  is  very  effective 
in  lowering  blood  pressure.  In  this  instance  however, 
the  thermic  effect  is  less  perceptible  than  with  the  other 
methods,  and  lends  the  strongest  argument  to  a  theory  that 
the  action  in  lowering  blood  pressure  is  upon  the  neuro- 
muscular mechanism  of  a  sort  peculiar  to  the  high  poten- 
tial electrical  currents,  and  not  to  heat  production. 


CIlArTEK  V 

MSKASKS  OF  THI";  NKRVOFS  SYSTEM 

Diseases  of  tlio  utTvous  system  (-(nisidertHl  from  tlie  thora- 
ppiitic  point  <tf  view  may  bo  ("las*;itio(]  as  ( 1 )  those  of  c(mi- 
tral  <)ri<;iii  assoeiattnl  witli  lesions  of  the  hraiii  or  spinal 
cord;  as  (2)  peripheral  intlammatory  lesions  affecting 
the  nerve  trunks;  and  (3)  rcHex  or  functional  neuroses 
havinj^  their  oritjin  usually  associated  with  lesions  or  dis- 
turbances of  the  sympathetic  system;  and  presenting;  men- 
tal or  j)sychic  sympt«mis  referrable  to  the  central  nervous 
system. 

Inflammatory  affections  are  in  most  cases  the  cause  of 
diseases  of  the  neiTous  system  a.s  of  other  parts  of  the 
body.  These  arise,  likewise,  from  infection,  toxemia, 
mechanical  injury,  and  errors  of  metabolism. 

///  the  tnainicnt  of  diseases  of  the  cvntnil  uervoits  sys- 
tem, the  therapeutic  indications  <lepend  upon  the  relief 
as  far  as  possible  of  central  lesions  and  the  systematic 
treatment  of  i>eriplieral  conditions  for  the  purpose  (»f  main- 
taining i)eripheral  metal>olism.  In  these  cjises  nutrition 
and  function  may  be  a  long  time  maintained  by  peripheral 
stimulatiim.  Lesions  of  the  hrain  are  practically  beyond 
relief  from  the  applications  of  high  j)ot<'ntial  currents, 
except  in  so  far  as  blood  pressure  may  lie  controlled  and 
central  lesions  Ik*  reflexly  influencfsl  and  nutrition  im- 
proved. 

Mental  (Uranqements  cannot  in  all  cas4's  be  referred  to 

ISl 


182  HIGH-POTENTIAL  CURRENTS 

lesions  of  the  central  nervous  system.  Only  those  cases 
in  which  an  active  lesion  is  present  can  be  classified  under 
this  head;  the  others  will  be  treated  as  reflex  or  functional 
neuroses.  It  has  been  claimed  by  some,  that  in  cases  of 
cerebral  hemorrhage,  by  passing  a  mild  galvanic  current 
through  the  base  of  the  brain,  it  was  possible  to  hasten  the 
absorption  of  the  clot.  This  may  be  so,  but  it  cannot  be 
generally  accepted  owing  to  the  mild  currents  which  musit 
be  employed  in  these  cases,  such  as  could  not  affect  the 
cerebellar  portions  of  the  brain. 

The  treatment  of  apoplexy  may  be  prophylactic  when  a 
condition  of  high  blood  pressure  with  a  pending  crisis 
from  advanced  arterio-sclerosis  is  early  enough  discov- 
ered. Such  cases  under  careful  observation  and  regulated 
diet,  with  the  blood  pressure  kept  under  control  as  de- 
scribed in  the  previous  chapter,  can  be  kept  for  many 
years  from  the  danger  of  apoplexy,  even  after  a  first 
attack.  When  apoplexy  has  occurred,  there  is  no  measure 
that  will  accomplish  so  much  as  the  combined  effects  of 
body  administrations  of  radiant  light  and  heat  and  d'Ar- 
sonvalization  in  facilitating  a  rapid  absorption  by  the 
induction  of  arterial  dilatation,  thereby  increasing  the 
circulation  and  metabolism  in  the  brain,  as  of  the  rest 
of  the  system. 

The  inroads  of  degeneration  of  the  hrain  cells,  associated 
with  advancing  arterio-sclerosis,  may  likewise  be  impeded, 
and  nutrition  preserved  by  the  employment  of  d'Arson- 
valization  by  the  auto-condensation  and  auto-condxiction 
methods.  There  can  be  no  contra-indications  for  the 
employment  of  these  in  cerebral  cases,  unless  for  some 
reason'  a  high  blood  pressure  due  to  compression  of  the 
brain  cells  may  be  compensatory. 


DISEASES  OF  THE  NERVOUS  SYSTEM      183 

In  tumors  of  the  brain,  the  effects  of  mec'luiuical  injury, 
syphilitic  lesions,  or  from  other  causes,  it  is  doubtful  if 
external  treatauent  is  <>f  any  a\'ail,  as;  the  ix^ny  eaj>sule 
makes  it  impossible  to  pnHiuce  any  direct  physical  effect 
upon  the  structur(>^  of  the  brain. 

In  difitafics  of  the  spinal  cord,  the  coudition.s  are  more 
favorable  to  treatment  than  of  the  brain.  Incascnl  in  a 
bony  canal,  and  with  the  liji^aments  surrounding  the  joints 
of  the  vertebra,  the  cord  is  not  eavsy  of  access  by  low 
potential  currents  except  through  reflex  stimulation.  It 
is  jMKssible  however  to  locallj*  affect  these  structures  by 
the  high  potential  currents,  particularly  the  static  wave 
current  and  static  sparks.  Tliis  has  l>een  demoustrated 
in  the  vsuccessful  treatment  of  conditions  the  result  of 
mecliiuiical  injury,  affecting  the  cord  and  surrounding 
capsule.  No  lesion  is  more  intractable  to  the  older  methods 
of  treatment  than  spinal  arthritis  and  tul>ercular  lesions 
both  of  which  respond  to  the  high  potential  currents;  the 
former  by  the  application  of  the  static  wave  curn'ut  and 
static  sparks,  and  the  latter  by  the  direct  d'Arsouval  in 
accordance  with  the  general  principles  of  treatment  of  the 
two  different  types  of  inflammation  as  considered.  lu 
lesions  of  the  cord  associated  with  mechanical  injuries, 
except  those  in  which  actual  fracture  of  the  vert-<'bra  has 
tiiken  place,  these  modalities  are  prompt  and  effective,  as 
indicated  by  the  following  case: 

Mr.  M.,  injured  in  a  head-on  collision  in  a  railroad  acci- 
dent, sustained  a  concussion  at  the  base  of  the  brain  with 
a  region  of  swelling  and  tenderness  over  the  first,  second, 
and  third  cervical  vertebra,  and  a  sj>inal  injury  at  the 
junction  of  the  eleventh  and  twelfth  dor.sal.  Eight  days 
after  the  accident  the  patient  had  ma<le  no  improvement 


184  HIGH-POTENTIAL  CURRENTS 

when  he  came  under  the  writer's  observation.  The  left 
side  was  partly  paralyzed,  the  gait  very  labored  and  shuf- 
fling, with  complete  inability  to  raise  the  right  hand.  The 
left,  side  of  the  body  was  in  a  state  of  choreic  movement, 
including  the  arm,  neck  and  left  leg.  His  reflexes  on  tJiat 
side  were  all  exaggerated;  so  much  so  that  a  tap  on  the 
patellar  tendon  would  throw  the  patient  into  convulsions. 
He  was  treated  wdth  the  static  wave  ciu'rent,  a  narrow 
metal  electrode  being  placed  over  the  upper  cervica.1  region 
and  extending  to  the  middle  of  the  dorsal  for  twenty 
minutes.  A  spark-gap  nine  to  twelve  inches  in  length  was 
employed.  This  was  followed  by  a  second  administration 
to  the  lower  dorsal  and  lumbar  region  of  the  vertebral 
column.  This  administration  was  given  twice  daily  with 
marked  improvement  from  the  first ;  and  at  the  end  of  ten 
days  he  could  use  his  paralyzed  arm,  the  choreic  move- 
ments of  the  other  side  had  almost  entirely  ceased,  and 
he  was  able  to  go  about  town.  At  the  end  of  three  months 
every  evidence  of  the  affection  had  disappeared.  The 
gravity  of  the  condition  was  apparent  from  the  fact  that 
the  railroad  settled  his  case  early  on  the  advice  of  their 
physician,  paying  him  upwards  of  |14,000.  The  same 
result  has  been  obtained  in  the  treatment  of  all  similar 
cases  of  arthritis  of  the  spinal  column,  including  the  lum- 
bar sprains.  These  results  demonstrate  the  capacity  of 
the  current  to  penetrate  to  the  deep  spinal  centers. 

In  anterior  poliomyelitis  applications  of  the  wave  cur- 
rent to  the  spine  in  the  manner  described  have  been  fol- 
lowed in  all  early  cases  by  plienomenal  results.  The  im- 
provement in  all  early  eases  is  pronounced ;  while  in  older 
cases  the  improvement  is  often  marked  but  the  prognosis 


DISEASES  OF  THE  NEKVorS  SYvSTEM      1S5 

is  not  so  good  from  the  fact  tliat  tlio  lesion  has  already 
destroyt'<l  many  of  the  spinal  centers. 

The  indications  for  treatment  in  anterior  poliomyelitis 
are  to  produce  an  active  metabolism  in  the  involved  section 
of  the  cord  in  order  to  promote  the  elimination  of  the 
congestion  or  infiltration  which  has  occnrnnl  incident  to 
the  local  lesions  whatever  the  (a-igin.  The  latest  investi- 
gations of  Flexner  and  his  associates  would  indicate  that 
the  disease  is  of  infectious  origin.  If  so,  the  daniagc  has 
been  done  when  the  paralysis  occurs,  and  the  infiltration 
will  iK^rsist  even  after  the  removal  of  the  canst',  which 
is  active  as  indicated  l)y  the  fever,  rarely  ])res(*nt  for 
more  than  two  or  three  days.  The  elfei-t  of  the  process, 
however — the  infiltration  i)roducing  pressnri' — will  per- 
sist unless  some  means  is  employed  to  remove  it. 

For  treatment  during  the  acute  stage,  probably  n(t  agent 
is  more  beneficial  than  prolonged  applications  of  radiant 
light  and  heat,  which  will  produce  a  general  hyperemia  of 
the  skin  of  the  whole  body,  thereby  drawing  away  much 
of  the  fluids  from  the  region  of  probable  congestion,  and 
at  the  same  time  eliminating  the  toxic  products  of  the 
infection  by  the  channel  of  the  perspiration,  which  is  in- 
duc«Ml  by  the  application. 

The  apidicati<>n  (►f  radiant  liglit  and  heat  should  be  fol- 
lowed after  the  first  forty-eight  hours,  at  least,  by  the  daily 
application  of  the  static  wave  current  for  twenty  minutes 
with  a  narrow  electrode  ai>proxiniatt'ly  one  inch  in  widih 
over  the  regi()n  of  the  cord  atfecte<l.  In  cases  involving 
the  wli<de  length  of  the  ciu'd  fri>m  the  upper  cervical  to 
the  lower  lumbar  region,  the  mistake  liable  to  be  made 
by  operators  is  due  to  a  disp<>sition  to  use  too  short  a 
spark-gap   with    the  static    wave   current,   whereas,   even 


180  HIGH-POTENTIAL  CURRENTS 

with  small  children,  the  spark-gap  should  be  of  consider- 
able length — ^six  to  ten  inches.  The  size  of  the  terminal 
balls  of  the  discharging  rods,  which  allow  a  greater  or 
less  degree  of  charge,  should  be  regulated  to  the  size  or 
age  of  the  Individual.  These  should  be  varied  from  V2 
to  11/4  inches  in  diameter  according  to  the  age  or  muscular 
development  of  the  patient.  It  must  always  be  appre- 
ciated by  the  operator  that  the  current  employed  is  of  such 
small  amperage  and  so  widely  diffused  throughout  the 
body  of  the  patient  in  passing  to  and  from  the  periphery, 
that  the  element  of  danger  is  no  greater  than  from  a 
shower  bath ;  and  also,  that  the  greatest  current  condensa- 
tion associated  with  muscular  responses  is  immediately 
beneath  the  surface  of  the  electrode,  causing  the  influence 
to  be  very  active  upon  the  structures  of  the  cord. 

The  effects  of  the  current  under  these  conditions  as  evi- 
denced by  the  prompt  tendency  to  recover  motor  functions, 
is  marked  and  positive  usually  from  the  first  administra- 
tion. Even  in  cases  of  relatively  longer  standing,  this  is 
noticed,  though  the  extent  of  recovery  is  less  in  proportion 
as  the  condition  has  been  present  for  a  long  time.  If 
for  any  reason  one  limb  or  part  persists  in  a  condition  of 
disability,  greater  energy  should  be  employed  over  the  cor- 
responding region;  because  greater  hemorrhage  and  crip- 
pling of  cells  in  their  function  has  taken  place  in  the 
corresponding  part  of  the  cord. 

In  order  to  avoid  atrophy,  which  is  so  marked  and 
pathognomonic  of  lesions,  affecting  the  portion  of  the  cord 
involved,  it  is  important  that  the  peripheral  nutrition  of 
the  paralyzed  muscles  be  maintained,  and  in  the  later  cases 
that  they  be  stimulated.  It  has  been  for  a  long  time  the 
practice  of  the  profession  to  employ  the  constant  and 


DISEASES  OF  THE  NERVOUS  SYSTEM      187 

indiictHl  currents  over  the  affected  muscles.  After  an  ex- 
teiuled  experience,  however,  the  author  has  demonstrated 
the  greater  benefits  to  be  derived  fnmi  the  employment 
of  radiant  light  and  heat  and  interrupted  mechanical  vibra- 
tion, gently,  but  actively  employed  over  tliesi'  muscles,  at 
tirst  daily,  and  later  on  alternate  days.  Masmgc  may  be 
employtxl  at  intervals  but  is  undoubtedly  of  less  efficiency 
than  tile  more  practical  and  energetic  application  of  me- 
chanical vibration,  employing  a  small  flat  disc  apijlicat-or 
to  all  the  muscles  of  the  affected  parts.  It  is  possible  by 
these  nieams  to  prevent  atrophy  in  the  limb  when  employed 
from  the  first  for  months,  though  paralysis  may  have  per- 
siste<l.  Thev  are  therefore  valuable  for  maintaining  the 
muscles  and  other  parts,  pending  the  relief  of  the  corre- 
sp>onding  centers  in  the  cord. 

77<e  profjnosis  under  routine  treatment  is  relative  to  the 
promptness  with  which  it  is  instituted,  few  cases  failing 
to  make  complete  or  prompt  recovery,  when  the  treatment 
described  is  instituted  early,  and  later  it  is  relative  to 
the  extent  of  damage  done. 

In  tabes  dorsalis  the  lesion  is  a  progressive  sclero.sis 
due  to  an  inflammatory  process,  the  exact  character  of 
the  origin  of  which  has  not  been  discovered,  though  too 
<>ften  attributed  to  sj'philis.  Fully  fifty  per  cent,  of  the 
author's  cases  have  given  an  unquestioned  negative  diag- 
nosis as  to  svphilitic  origin,  though  the  Wassermann  re- 
action of  recent  institution  had  not  l)een  employtnl  to 
confirm  the  diagnosis.  So  many  ca.ses  have  given  instead 
a  history  of  spinal  concussion  that  it  is  liopeful  that  this 
methcKl  of  diagnosis  will  eventually  deny  the  statement, 
until   recently   .so  generally   proclaiuHMl    by   neurologists. 


188  HIGH-POTENTIAL  CURRENTS 

that  it  is  invariably  of  syphilitic  origin — an  imputation 
unjust  to  the  innocent. 

TliG  indications  for  treatment  of  tabes  dorsalis  are  first 
of  all  practically  directed  to  the  treatment  of  the  cord 
lesion  as  in  anterior  poliomyelitis  for  which  the  static 
current  is  employed.  The  static  wave  current  with  a  long 
nari^ow  electrode  over  the  spine  employing  a  long  spark- 
gap  for  twenty  minutes  is  remarkably  effective  in  relieving 
the  pain  of  tabes,  and,  in  many  cases,  eventually  arrests 
the  process  in  the  cord. 

The  conditions  of  muscular  contraction  particularly  in- 
volving the  lower  extremities  and  back  in  tabes,  are  also 
relieved  by  the  static  wave  current  and  sparks  in  con- 
junction with  applications  of  mechanical  vibration  to  the 
motor  points  and  tense  muscles,  wherever  found,  in  ac- 
cordance with  the  principles  of  relieving  muscular  spasm 
with  these  modalities.  This  relief  however  is  only  tempor- 
ary unless  the  central  lesion  is  favorably  affected. 

Areas  of  anesthesia,  which  are  usually  marked  in  the 
extremities  below  the  knees,  particularly  in  the  leg,  are 
best  diagnosed,  both  as  to  extent  and  degree,  by  the  pas- 
sage of  the  brass  bn!l  electrode  over  the  clothing.  The 
pear-shaped  sparldng  ball  w^as  suggested  and  designed  by 
the  writer  for  the  treatment  of  these  cases.  Friction 
sparks  applied  in  this  manner  will  elicit  the  extent  and 
degree  of  anesthesia;  and  when  applied  systematically  for 
the  requisite  time  by  passing  the  ball  over  tlie  clothing, 
it  is  surprising  how  much  the  sensibility  of  the  part  is 
restored  by  the  application.  Likewise  the  application  of 
short  sparks  to  the  soles  of  the  feet  is  capable  of  increasing 
the  sensibility  in  the  nerves  of  the  integument  here  also. 
Applied  in  this  manner  during  the  course  of  treatment, 


DISEASES  OF  THE  NERVOUS  SYSTEM      189 

theiv  will  Ix'  u  marked  tlimiiiulii)ii  of  aiii'sthesia.  Some 
attribute  this  to  the  effect  upon  end  neurons,  and  others 
as  due  to  the  ingoin*;  impression  conveyed  to  the  central 
neurons,  by  which  their  function  is  increased.  Be  this  as 
it  may,  tJie  emj)loyment  of  friction  sparks  over  the  anes- 
thetic areas  in  this  way  is  remarkably  etYe«tive  in  assisting 
to  relieve  the  anesthesia. 

The  jKtiits  of  iahes  are,  as  a  rule,  diminished  during 
a  course  (►f  treatment  by  the  static  wave  curi*ent,  and  are 
finally  entirely  removed  for  lonjjj  periods  in  ciuses  who 
attend  strictly  to  treatment.  During  the  paroxysms  the 
pain  is  remarkably  relieved  by  showers  of  short  sparks 
applied  directly  over  the  seat  of  pain.  It  is  often  possible 
to  completely  arrest  the  terrible  pains  of  tabas  by  such 
seven*  applications  of  short  sparks  to  the  painful  areiis. 

The  girdle  sensation  may  persist  after  all  other  symp- 
toms have  disappeared,  and  is  the  most  stubborn  symptom 
to  treat,  though  static  sparks  and  mechanical  vibration 
over  the  pt>sterior  roots  and  the  contracted  muscles  do 
intluence  to  a  degi'ee  this  symptom. 

The  tabetic  or  ataxic  icalk  is  greatly  relieved  by  the 
removal  of  tension  from  the  contracted  muscles,  and  the 
relief  of  anesthesia  in  the  feet.  While  co-ordination  may 
remain  much  impair<Ml.  education  in  the  us<'  of  the  musi^les 
— teaching  the  patient  to  walk  in  a  normal  manner  under 
the  exerci.se  of  will,  together  with  the  institution  of  daily 
systematic  exercise  in  the  perfornmnce  of  the  necessary 
movements,  t(^gether  with  the  realization  of  the  most  im- 
portant rule  of  I'Yaenkel,  that,  "  the  individual  walks  with 
his  bo<ly,  and  not  with  his  limbs,"  in  other  words,  that  the 
carriage  of  the  Inxly  forward  is  what  causes  the  limbs  to 
move,  to  maintain  the  equipoi.se,  giving  a  forward  impetus 


190  HIGH-POTENTIAL  CURRENTS 

to  the  movement  of  the  whole.  It  is  unreasonable  to  sup- 
pose that  training  in  walking  can  accomplish  any  perma- 
nent benefit  in  the  progress  if  the  pathological  process 
is  not  arrested. 

The  Argyll  Robertson  pupil  and  the  patellar  reflexes  are 
not  apt  to  be  restored  even  in  the  early  cases  of  tabes, 
though  the  progress  of  the  lesion  may  undoubtedly  be 
arrested. 

A  dilated  bladder  may  be  remarkably  improved ;  and  the 
vesical  symptoms  almost  uniformly  relieved  by  rectal  treat- 
ment, or  the  employment  of  an  abdominal  electrode  above 
the  pubes.  The  action  of  the  wave  current  in  these  cases 
is  to  throw  the  parts  into  active  exercise,  that  is,  stimu- 
lating the  action  of  muscular  fibres  of  the  parts  so  treated, 
and  increa^dng  tone,  metabolism  and  nutrition. 

The  prognosis  in  tahes,  under  this  plan  of  treatment 
will  vary  very  largely  in  different  cases  and  must  depend 
upon  the  results  of  treatment.  A  few  eases  may  not  re- 
spond to  be  materially  benefited  though  in  most  cases 
an  arrest  will  be  instituted.  In  fully  seventy-five  per  cent, 
of  the  cases  in  the  writer's  experience,  the  improvement  is 
marked  from  the  first,  and  in  at  least  fifty  per  cent,  an 
arrest  of  the  progress  of  the  disease  is  effected.  The 
length  of  time  required  to  effect  these  results  will  vary 
in  different  cases.  The  patient,  however,  from  the  begin- 
ning of  treatment  should  be  instructed  to  expect  that  it 
will  require  a  long  course  of  treatment  to  effect  satisfac- 
tory results  in  these  cases.  Daily  treatments  should  be 
given,  or  at  least  six  times  weekly  during  the  first  two 
or  three  weeks,  followed  by  alternate  day  treatments  and 
less  frequent  as  the  progress  will  indicate,  for  at  least  a 
year.    Patients  should  be  kept  under  observation  for  many 


DISEASES  OF  THE  NERVOUS  SYS^TEM      101 

years,  applyinj;  for  relief  promptly  whenever  there  is  any 
recurrence  of  active  Kyinptoiiis. 

No  plan  of  treatment  ofTers  s<>  miK  h  for  these  sufferei*s 
as  the  combined  employment  of  statie  electricity  and  me- 
chanical vibration,  together  with  the  institution  of  sj'ste- 
matic  exercise,  the  employment  <»f  which,  without  treat- 
ment direct-eil  to  the  lesion,  is  irrational. 

In  spastic  paraplegia,  it  is  possible  to  temporarily  arrest 
th<'  annoying  svnnpt^ms  of  muscular  contraction  and  spas- 
modic movement  and  improve  the  walk;  but  it  is  doubtful 
whether  more  than  a  temporary  arrestment  of  the  ])ro('(»ss 
is  accomplished,  though  a  tcmjH>raiT  arrest  has  been  dem- 
onsd^rat'Cd  by  the  writer.  The  stiitic  wave  current  is 
applieil  in  these  cases  to  the  part  of  the  spine  in  wliieit 
the  lesion  is  demonstrateil ;  usually  in  the  lower  extremi- 
ties. The  disturbing  vesical  irritation  is  likewise  ma- 
terially benefited  by  the  siune  treatment. 

///  lateral  sclerosis  in  the  early  stages,  and  transverse 
myelitis,  the  rational  treatment  is  the  employment  of  the 
static  wave  current  as  d<^scribed  in  other  cord  lesions  as 
it  has  .shown  markeil  l)eueiicial  results  in  the  treatment  of 
the  writer's  cases. 

In  syrin4jomyelia  which  is  not,  we  believe,  so  often 
an  incurable  condition  ;is  has  Itccn  supposed,  if  timely 
treatment  is  instituted  tlie  lo<-al  indurati<ni  of  the  cord 
substance  will  U-  relieved  and  the  degcnt'ration  arrested. 
One  case  referred  to  the  writer  which  had  been  under 
ob.servation  in  one  of  the  Icadini;  c(>Il<'gc  clinics  of  the 
city,  with  a  progressive  lo.ss  of  iH)wer  in  one  forearm  for 
three  years  under  tn'atment,  after  having  the  static  wave 
cui'rcnt  applied  over  th<'  spine,  and  the  api>lication  of 
mechanical  vibration  an«i  light  to  the  anesthetic  areas,  was 


192  HIGH-POTENTIAL  CURRENTS 

completely  arrested  and  followed  by  restoration  to  normal 
tactile  sensibility  of  nearly  all  of  tlie  anesthetic  area  which 
included  most  of  the  surface  of  the  forearm ;  only  one  very 
smaill  area  persisting.  The  atrophy  which  had  begun  in 
the  hand,  involving  the  thumb  muscles,  ceased  to  progress, 
and  after  an  elapse  of  three  years  there  was  no  recurrence 
of  the  symptoms.  It  is  probable  that  similar  treatment 
in  other  cases  will  be  followed  by  similar  result^s. 

In  chorea  major  the  conditions  of  general  hyperasthesia 
and  reflex  irritability,  emanating  probably  from  an  active 
hyperemia,  in  the  cord,  has  been  promptly  relieved  by  the 
author,  by  the  application  of  static  insulation  with  a  long 
spinal  electrode  extending  from  the  dorsal  to  the  upper 
cervical  region — the  machine  running  at  a  rapid  rate  with 
the  balls  so  widely  separated  that  no  spark  can  discharge 
across  the  gap,  together  with  the  peripheral  application 
of  radiant  light  and  heat  to  the  whole  body  to  the  extent 
of  producing  a  general  hyperemia. 

Pachymeningitis,  involving  the  meninges  of  the  cord, 
and  other  hyperemic  conditions,  as  those  associated  with 
hysteria,  are  rationally  treated  and  usually  promptly  bene- 
fited by  the  application  of  the  static  wave  current  over 
the  cord  as  described  in  the  treatment  of  other  cord 
affections. 

The  treatment  of  these  conditions  is  rational  and  we 
axe  glad  to  say  effective  in  so  many  of  these  otherwise 
intractable  conditions,  that  they  are  cordially  recom- 
mended to  the  reader.  To  be  effective,  however,  it  must 
be  borne  in  mind  that  a  long  spark-gap  is  required  when 
the  wave  current  is  applied  to  the  cord  over  the  vertebral 
column,  regulated,  however,  to  the  physical  conditions  of 
the  patient;  with  the  average  adult  employing  terminal 


DISEASES  OF  THE  NERVOUS  SYSTEM      103 

balls  oil  the  discliarjnnc:  nxls  ono  and  one-fourth  inches 
in  diameter.  As  in  all  inllainiiiatory  conditions  the  wave 
current  is  admiuist^i*ed  for  twenty  minutes  at  each 
treatment. 

The  pcriiiheral  affections  of  the  ncrvoufi  system  include 
those  associatinl  with  disturbances  of  circulation  with  the 
production  of  pain  or  other  disturbances  of  sensation; 
most  of  the  latter  of  which  however  are  of  central  origin. 
Of  these  the  diflferent  types  of  neuritis  are  of  greatest  sig- 
nificance. 

Neuritis  is  usually  designated  according  to  location; 
and  very  often  by  miisnomer  is  termed  neuralgia;  as  neu- 
ritis of  the  face  is  very  frequently  called  facial  neuralgia, 
and  also  of  the  sciatic,  sciatic  neuralgia.  Until  the  prob- 
lem of  treating  neuritis  ha.s  become  a  relatively  simple 
one,  and  the  lesion  may  now  be  readily  and  systematically 
located,  it  is  easy  to  understand  how  the  term  neuralgia 
came  into  medical  literature.  At  best  the  term  Ls  an 
expression  of  indifference  to  diagnosis;  for  neuralgia  can 
never  be  recognized  as  other  than  a  symptom. 

The  therapeutics  of  neuritii'i  recognizes  a  local  inflam- 
matory process  with  the  indication  for  treatment  the  same 
a.s  in  other  non-infected  inflaiiimatory  processes, — the  dis- 
persion of  infiltration  with  the  relief  of  pressure  and  pain. 

The  diagnosis  of  neuritis,  or  localization  of  the  seat  of 
the  le.sion,  is  easily  effected  with  the  static  wave  cuiTent 
applietl  through  the  medium  of  a  flexible  metal  electrode 
directly  over  a  suspected  Rite;  wluii  if  present,  it  elicits 
a  degre<'  of  pain  which  is  diagnostic  in  comi)arison  with 
tJiu  ellVct  u|H)n  the  normal  tissues.  The  pain  arising  from 
causing  C(>ntraction  of  tense  muscles  by  the  wave  cur- 
rent, may  very  often  Ik?  mistaken  for  the  pain  due  to  a 


194  HIGH-POTENTIAL  CURRENTS 

lesion ;  because  when  muscular  contraction  exists,  the  in- 
tense stimulus  increasing  the  contraction,  will  cause  pain 
until  the  muscles  gradually  relax.  This  relaxation  how- 
ever will  be  effected  within  the  first  five  or  ten  minutes, 
when  if  the  spark-gap  is  lengthened  considerable  no  mare 
pain,  is  produced;  whereas  over  the  lesion  of  neuritis, 
during  the  first  administrations,  the  pain  will  during  the 
seance  persist  with  the  gradual  lengthening  of  the  spark- 
gap  for  the  full  twenty  minutes  of  the  treatment. 

The  prognosis  as  to  time  necessary  to  cure  neuritis  will 
depend  upon  the  length  of  time  that  the  process  of  exuda- 
tion and  infiltration  has  been  present.  In  long  standing 
cases  the  exudation  often  becomes  organized,  and  the 
nerve  adherent  to  the  surrounding  tissues.  In  these  cases 
the  impairment  of  the  nutrition  of  the  limb,  and  persistent 
disturbance  on  use  on  locomotion  of  the  limb  will  be 
marked  and  the  length  of  time  necessary  to  effect  the 
restitution  of  the  parts  supplied  by  the  nerve,  will  depend 
upon  the  region,  extent,  and  character  of  the  local  lesion. 
In  cases  in  which  the  lesion  is  witliin  the  pelvis,  and  above 
the  sacro-iliac-synchondrosis,  the  prognosis  will  be  uni- 
formly bad ;  because  it  will  not  often  be  possible  to  affect 
an  induration  so  remotely  situated. 

There  are  certain  places  where,  on  account  of  exposure 
to  pressure,  violent  muscular  action  and  external  violence, 
neuritis  is  liable  to  occur.  The  most  common  sites  are 
where  the  sciatic  nerve  passes  through  the  sacro-sciatic 
notch  beneath  the  pyraformus  muscle;  where  the  crural 
emerges;  where  the  large  nerve  trunks  cross  the  sacro- 
iliac-synehondrosis;  where  the  musculo-spiral  and  circum- 
flex emerge  beneath  the  teres  minor;  where  the  supra-scap 
ular  passes  out  from  beneath  the  trapezius,  and  through 


DISEASES  OF  THE  NERVOUS  SYSTEM      1!)5 

the  snpra-spiiuitoiis  fossii  of  the  seapiila;  whore  the  in- 
feritu-  (h'lital  i)asst\s  into  the  eaiial  in  the  inferior  maxillary 
bone;  and  where  the  s'uperior  maxillary  branch  of  tJie 
tifth  nei-Ae  passes  through  the  infra  (»rliital   f()ramen. 

'AVhen  a  lesion  is  IcK-ated  at  these  points,  the  origin  may 
be  attributed  as  a  rule  to  mechanieal  eauses  ami  exposure 

In  herpes  zoster  and  intercostal  neuritis  the  lesion  will 
generally  be  locate<i  where  the  posterior  roots  emerge  from 
the  spinal  coluann. 

Other  causes  than  inecJianieaJ  injury  or  exposure  are 
from  toxemia  or  local  infection,  which  cases  respond  to 
treatment  by  intestimil  antiseptics.  The  cases  occurring, 
however,  at  the  sites  enumerated  may  but  rarely  be  at- 
tributed to  toxemia  or  infection. 

The  treatment  of  neuritis,  either  of  mechanical  or  in- 
fectious origin,  is  practically  the  siime,  except  that  in  the 
early  stages  in  patients  in  which  a  toxemia  may  be  sus- 
pected, the  use  of  aspirin  or  salicylates  may  prove  bene- 
ficial. Exceptional  cases  may  recover  spontaneously  ;  but, 
as  a  rule,  no  class  of  conditions  is  more  stubi>orn  or  re- 
sisting to  other  methods  of  treatment. 

The  usual  methods  employed  at  the  present  time  by 
physicians  and  neurologists  not  familiar  with  more  prac- 
tical methods  aiv  to  put  the  patient  to  bed  with  tixation 
vsplints,  nerve  stretching  and  surgical  operation.s,  Turki.sh 
baths,  and  nuussage,  and  tnvitment  at  various  hwiltli  re- 
sorts aM<l  spa>:,  by  similar  measures.  These  have  be<'n 
folk>we<l  quite  uniformly  with  unfavorable  results,  as  evi- 
denced by  the  numl)er  of  cases  that  are  uncured  by  them. 

The  static  wave  current  and  static  sparks  are  so  uni- 
formly successful  in  the  treatment  of  these  cases,  that  it 
is  to  be  deplored  that  so  many  are  ignorant  of  that  method 


196  HIGH-POTENTIAL  CUKRENTS 

of  treatment.  In  all  cases  In  which  an  electrode  can  be 
plajced  immediately  over  the  site  of  the  lesion,  the  applica- 
tion is  both  diagnostic  and  curative,  if  used  with  the 
proper  energy  in  connection  with  direct  applications  of 
static  sparks  to  the  lesion.  By  these  means  it  is  possible 
to  remove  the  infiltration  surrounding  the  nerve,  and  by 
daily  applications  to  effect  a  complete  relief,  by  the  re- 
moval of  the  pressure  upon  the  nerve,  finally  restoring 
the  nerve  to  a  normal  condition.  In  the  early  cases,  within 
the  first  two  weeks,  the  results  of  treatment  are  very 
prompt  and  effective.  It  is  possible  in  any  accessible 
neuritis  before  adhesions  have  occurred,  or  tissue  organiza- 
tion to  effect  a  cure  in  a  few  days.  The  writer  bas  verified 
this  in  seventy  cases  of  acute  sciatica,  all  of  which  have 
been  cured  within  ten  days.  The  same  is  true  of  brachial 
neuritis,  facial  neuritis,  and  herpes  zoster. 

The  technique  e^nployed  in  the  treatment  of  these  cases 
is  the  application  of  the  static  wave  current  with  a  fiex- 
ible  metal  electrode  applied  directly  over  the  site  of  the 
lesion.  A  spark-gap  which  produces  a  bearable  pain  is 
employed  from  the  outset,  and  gradually  lengtliened  dur- 
ing tbe  twenty  minutes  allowed  for  this  application.  If 
at  the  end  of  the  wave  current  administration  there  are 
muscular  contractions  which  limit  the  motion,  or  cause 
pain  upon  movement  of  the  affected  limb  or  part,  the 
application  of  sparks  to  all  such  muscles  is  indicated,  the 
patient  moving  the  arm  or  leg  in  different  positions, 
sparking  the  muscles  where  tension  is  present  until  con- 
siderably, if  not  entirely  relieved,  which  will  be  followed 
by  a  general  feeling  of  lightness  and  mobility  and  the 
patient  will  be  able  to  continue  his  work  during  the  course 
of  treatment. 


DISEASES  OF  THE  NERVOUS  SYSTEM      1!>7 

In  tic  doiilourcud-  ov  fdciul  neuritis  tht'  application  of  the 
wave  curivnt  should  be  followed  by  the  sUitie  brush  dis- 
chai'ge  and  statir  sparks,  making  a  tlior(>u«!:li  application 
over  the  wh<de  surface;  also  iu  supra-orbital  neuritis,  or 
her])es  of  the  scalp.  If  })ortions  of  the  nerve  arc  involvc<l 
that  can  be  best  reached  within  the  mouth,  as  at  the  inner 
surface  of  the  inferior  maxillarv  Ixuie,  (►r  l>elow  the  an- 
trum, th<'  use  of  tl»e  direct  vacuum  tube  current  applied 
internally  wiili  the  electrode  shown  in  Fi^.  4(1,  is  very 
etlicient. 

In  herpes  zoster  the  application  o(  radiant  li<;ht  and 
heat  to  the  extent  of  inducing  active  hyi>eremia  over  the 
affected  area,  followed  by  applications  of  deep  mechanical 
vibration  over  the  posterior  nerve  roots,  the  wave  current 


n 


Fig.  46.     Vacuum  Electrode  Desigued  for  Treatment  of  Tuugue  or  Tonsil. 

over  the  unerupteil  patches  and  the  brush  discharge  over 
the  herpetic  patches  give  prompt  and  almost  complete 
relief,  readily  curing  this  otherwise  intractable  affection. 

There  has  prol)ably  l>een  no  advance  made  in  thera- 
peutics which  is  of  more  striking  contrast  to  the  old 
metho<ls  than  the  advanced  meth<Kls  of  ti*eating  neuritis. 

Tlir  functioniil  neuroses  according  to  most  neurologists 
are  largely  of  psychic  origin,  and  are  often  dexignatcnl  by 
them  as  jK*<ychopathic  neuroses.  There  are  many  rejisons 
to  believe  that  very  few  if  any  of  the  so-called  psycho- 
pathic neuro.ses  are  purely  the  result  of  mental  environ- 
ment, but  in  mo«t  cases  are  associated  with  a  physical 
inflammatory  cause.     The  fact  that  the  neurologists  have 


198  HIGH-POTENTIAL  CURRENTS 

drifted  into,  what  it  may  seem  presumptuous  to  call,  a 
mistaJien  conception,  is  probably  due  to  the  fact  that  it 
has  been  so  long  that  the  remedies  have  been  ineffective, 
which  have  been  employed  to  remove  the  physical  condi- 
tions which  are  the  cause.  This  has  been  clearly  demon- 
strated in  many  instances  in  cases  who  have  been  in  the 
hands  of  these  gentlemen — cases  which  when  they  receive 
curative  treatment  directed  to  some  part  of  the  organism, 
particularly  to  the  pelvic  organs,  are  relieved  of  the 
psychic  phenomena. 

A  well  known  business  man,  a  former  patient  of  one  of 
the  best  known  New  York  neurologists  had  for  three  years 
been  under  treatment  for  neurasthenia.  He  came  under 
the  writer's  observation  and  was  treated  under  his  direc- 
tion for  prostatitis  associated  with  impotency,  and  made 
a  complete  recovery  in  a  few  weeks. 

Another  case,  referred  by  a  neurologist,  was  one  of  pus- 
tular acne  which  had  produced  a  profound  degree  of 
mental  depression  on  account  of  the  disfigurement.  The 
condition  was  cured  and  the  psychic  phase  disappeared. 
In  the  former  case  the  lesion  produced  a  functional  de- 
rangement, and  in  the  latter  the  impressions  were  psychic. 

In  the  author's  experience,  fully  twenty-five  per  cent, 
of  his  cases  of  prostatitis,  now  numbering  more  than  140 
cases,  have  been  subjects  of  neurasthenia,  and  were  cured 
of  bO'th  the  prostatic  and  psychopathic  derangement  by 
treatment  of  the  local  condition. 

The  author  was  first  impressed  with  these  views  seven 
years  since  fro^m  the  treatment  of  hysteria  in  a  female 
patient,  when  by  employing  the  static  wave  current  with 
a  metal  electrode  placed  in  the  rectum  in  the  treatment  of 
a  case  of  constipation,  a  hysteria  for  which  the  patient 


DISEASES  OF  THE  NERVOUS  SYSTEM      199 

had  been  refeiTed  to  the  writer  for  electrical  treatment, 
was  promptly  cured,  coincident  with  the  relief  of  the 
dysinenoiThea,  which  had  persisted  for  upwards  of  thir- 
teen years.  This  result  demonstrated  two  important 
truths:  (1)  the  efficiency  of  the  method  in  the  trtuitment 
of  dysmenorrhea;  and  (2)  that  with  the  cure  of  dysmen- 
orrhea there  will  often  be  prompt  subsidence  of  the  hyster- 
ical symptoms.  This  has  been  the  result  in  the  treatment 
of  a  large  number  of  similar  cases  of  neurasthenia  and 
hysteria,  from  the  treatment  of  some  pelvic  tN>nditi<ins, 
particularly  in  cases  of  prostatis  and  uterine  congestion. 
These  cases  are  cured  of  the  psychic  manifestations  when 
the  local  troubles  are  relieved  except  when  the  psychic 
condition  has  been  present  for  a  long  time ;  in  such  cases 
long  present  impressions  are  apt  to  be  fix<Hi. 

The  attitude  of  the  neurologists  on  this  subject  can 
probably  be  attributed  to  the  fact  that  the  gynecologists 
have  uniformly  resorted  to  surgei-y  in  the  treatment  of 
these  pelvic  conditions.  Surgical  methods  while  invalu- 
able in  selected  cases  either  dismember  and  render  the 
hys-teria  or  neurasthenia  worse,  or  prove  of  but  temiK>rai'y 
avail  in  many  cases,  particuhirly  in  the  cases  of  simi)le 
congestion  of  the  uterus,  and  prostate  gland.  The  removal 
of  either  the  prostate  gland  or  the  uterus  is  known  often 
to  produce  sei'ious  mental  derangenu'nt.  Curettage,  pro-s- 
tatic  massage,  and  rectal  or  vaginal  injtrtions  of  hi>t  water 
aiv  uniformly  ineffective  in  relieving  to  a  sufficient  degree 
either  uterine  or  prostiitic  congestion.  Unless  the  neurol- 
ogists are  willing  to  investigate  the  subjfH't  from  this  point 
of  view,  it  will  remain  for  the  general  i)ractitioners  or 
gj'necologists  or  genito-urinary  specialist's  who  are  familiar 
with  efficient  means  of  relieving  pelvic  congestion,  to  dem- 


200  HIGH-POTENTIAL  CURRENTS 

onstrate  the  correct  status  of  the  so-called,  functional 
neuroses. 

Another  class  of  affections  which  is  liable  to  lead  to 
neurasthenic  symptoms  are  the  derangements  of  the 
stomach  and  alimentary  canal;  often  from  hyperchlor- 
hydria,  and  conditions  associated  with  constipation  with 
intestinal  putrefaction  and  toxemia. 

There  are  also  many  cases  in  which  an  inherited  physical 
status  and  unsuitable  environment  may  develop  a  set  of 
psychopathic  symptoms.  To  presume,  however,  that  even 
these  cases  if  placed  under  proper  conditions  of  environ- 
ment and  hygiene,  in  happy  home  surroundings,  fulfilling 
the  natural  functions  of  existence,  are  certain  to  be  sub- 
jects of  neurasthenia  and  hysteria  without  other  physical 
cause,  is  contrary  to  experience;  for  when  under  adverse 
conditioHS  of  birth,  the  resulting  neuroses  may  generally 
be  averted  by  happy  surroundings  and  judicious  discipline. 
To  consign  cases  of  functional  neuroses  to  the  Christiani 
scientists,  or  other  psychic  healers,  without  directing 
treatment  largely  to  physical  conditions,  would  be  un- 
doubtedly to  compromise  the  best  interest  and  future 
health  and  'happiness  of  the  individual.  To  decry  the  em- 
ployment of  auto-suggestion  is  far  from  the  author's  intent, 
but  to  substitute  it  for  physical  treatment  when  actual 
physical  derangements  exist  is  bad  practice. 

The  proper  management  of  these  cases  employs  con- 
jointly a  healthy  suggestive  treatment  for  the  purpose  of 
exerting  the  proper  psychic  influence  upon  the  mind,  with 
the  rational  treatment  directed  to  the  relief  of  every 
physical  condition  discovered. 

The  diseases  designated  as  functional  neuroses  include 


DISEASES  OF  THE  NERVOUS  SYSTEM      201 

the  symptoms  complex  known  as  ncurafiihcnia,  In/strria, 
hi/pochondriasis,  fiinctionni  (•i)ilrjhsi/.  and  chorea. 

The  effort  to  di/fcrentintc  tlic  symptoms  wiiicli  shall 
make  a  clinical  pictui-c  of  the  first  three  conditions,  is 
quite  difficult;  and  we  believe  is  not  in  accord  with  what 
must  be  eventually  recoijnizeil  as  a  varying  effect  or  reflex 
which  may  affect  different  in<lividuals  jn  different  ways, 
even  when  causes  are  much  the  same.  In  other  words,  the 
differential  difiference  between  hysteria  and  neurasthenia 
which  was  once  stated  by  (lowers  to  be  one  of  sex,  at  the 
present  time  is  discountenanced  by  the  moilern  school  of 
neurologists;  though  it  may  have  embraced  more  of  truth 
than  is  now  acknowledged.  Freud  has  come  nearer  to 
what  seems  to  the  writer  to  be  the  correct  understiinding 
of  the  relation  of  the  sex  problem  to  functional  neuroses 
than  his  contemporaries.  The  sexual  organs  are  so  closely 
knitted  in  their  functions  and  nerve  supj)ly  with  the 
sympathetic  nervous  system  and  with  the  train  of  reflexes 
that  are  traceable  thi*ough  the  ramifications  of  the  symjya- 
thetic  nerve,  that  it  is  not  difficult  to  recognize  a  chain 
of  relations,  which  constitute  the  symptoms  complex  of 
these  neurases. 

The  treatment  of  functional  neuroses,  as  suggasted, 
should  be  directtnl  to  the  treatment  of  the  symptoms  com- 
plex. There  are  very  few  of  these  cases  which  do  not 
indicate  a  large  measure  of  perversion  in  all  of  the  nutri- 
tive ajs  well  as  sexual  functions.  The  .secretions  including 
the  skin  and  alimentary  secretion  are  inactive,  the  bowels 
are  as  a  rule  constii)ate<l,  and  most  of  the  ca.ses  are  sterile 
or  im[)otent.  Tiiat  the  treatment  of  these  patients  cannot 
be  efifective  by  one  means  of  treatment,  is  self-evident,  and 
the  absurdity  of  drug  treatment  1ms  been  likewise  demon- 


202  HIGH-POTENTIAL  CURRENTS 

strated  by  the  general  failure  to  cure  them  by  these  means. 
Radiant  light  and  heat  and  mechanical  vibration  as  indi- 
cated ;  d'Arsonvalization  for  the  treatment  of  hypertension 
when  present  and  the  static  and  high  frequency  currents 
in  the  treatment  of  the  two  types  of  pelvic  inflammation ; 
simple  and  infected,  each  plays  an  important  role  when 
indicated.  Regulate  the  rational  indications  to  each  indi- 
vidual case,  including  in  addition  to  the  means  enumer- 
ated the  systematic  regulation  of  diet,  exercise  and  envir- 
onment. It  is  impossible  to  expect  to  relieve  these  patients 
by  any  one  set  of  measures;  because  each  case  presents 
in  the  symptoms  complex,  varying  conditions  requiring 
individual  treatment  by  those  who  are  familiar  both  with 
the  i^mptoms  and  methods  of  treatment  to  be  employed. 

Under  a  rational  regime,  the  prognosis  is  good  in  early 
cases,  and  always  relative  to  the  effect  that  the  condition 
has  had  upon  the  mentality  of  the  individual.  In  long 
«?tanding  cases  it  cannot  be  expected  to  restore  to  normal 
a  depraved  or  perverted  mentality,  the  results  of  a  cumu- 
lative process  of  abnormality  or  perversion.  In  all  eases 
there  will  be  improvement,  and  in  cases  of  but  a  few  years^ 
standing  the  results  are  uniformly  good. 

Functional  epilepsy  or  epileptiform  attacks  of  reflex  not 
central  origin,  are  apt  to  arise  from  overfeeding  particu- 
larly with  excess  of  meat  diet  which  is  improperly  masti- 
cated. Some  cases  however  in  young  children  of  highly 
nervous  organization,  may  have  the  condition  aggravated 
by  various  local  conditions  of  the  genitals,  or  of  the 
mucous  cavities  as  adenoids,  and  in  others  it  may  be 
associated  with  eye  strain. 

The  indication  in  these  patients  is  to  remove  every  cause 
of  reflex  irritation,  and  establish  the  normal  functions  in 


DISEASES  OF  THE  NERVOUS  SYSTEM      203 

excry  part  of  tlu'  orgauisin,  toi^ether  with  restric-tion  ia 
the  matter  of  fiKKls  as  to  quality  and  quantity.  Meat 
should  be  entirely  omitted  in  most  cases. 

Treatment : — The  empkiyment  in  conjunction  with  regu- 
lation of  diet  and  habits  of  the  static  wave  current,  radiant 
light  and  heat  and  mechanical  vibration  is  indicated  for 
relief  of  conditions  to  which  they  are  adapted.  The  static 
wave  current  sliould  be  employed  daily  in  these  cases,  pre- 
ferably over  the  JiMomen,  with  the  prolonged  applietition 
of  radiant  light  and  heat  to  the  extent  of  inducing 
hypeivmia  to  the  trunk  of  the  bcnly,  with  the  additional 
application  of  mechanical  vibration  to  the  spine  and  for 
the  relief  of  constipation  or  any  other  condition  to  which 
such  application  is  adapted. 

Chorea  arises  from  practically  the  s;ime  cau.ses  as  func- 
tional epilepsy  and  the  indications  are  tlie  restoration  of 
every  impaired  physical  function  and  corrections  under 
practically  the  same  principles  as  those  suggested  in  the 
treatnu'nt  of  epilepsy.  The  static  wave  current,  however, 
should  not  be  applicnl  in  these  cases;  but  a  spinal  electrmle 
should  be  placed  directly  over  the  cord,  and  the  machine 
run  rapidly  with  the  balls  of  the  discharging  rods  widely 
sepiirated  in  ordcT  that  no  spark  will  discharge  across 
the  gap;  in  otluT  wonls,  the  administration  of  static  in- 
sulation through  the  me<lium  of  a  long  spinal  ekvtrode. 
A  prolonged  application  of  ra<liaiit  light  and  heat  to  the 
trunk  should  precede  the  static  treatment.  There  should 
also  be  restraint  in  matters  of  diet,  and  insistence  upon 
an  out-ofnloor  life,  away  fnmi  school  or  other  continement. 
Under  such  management  the  prognosis  i.s  g(K)d. 

The  following  case  will  illustrate  the  method  of  man- 
aging the^e  cases: 


204  HIGH-POTENTIAL  CURRENTS 

M.  L.  Child,  11  years  of  age,  had  suffered  from  chorea 
with  constantly  increasing  convulsive  movement  for  three 
months.  When  brought  for  treatment  the  child  was  in 
a  condition  of  general  convulsion  with  a  temperature  of 
101°  F.  It  was  with  difficult j  that  she  could  be  kept 
upon  the  table  or  chair,  owing  to  constant  involuntary 
movements  of  the  extremities.  The  knuckles  of  both 
hands  were  inflamed  from  constant  bruising  as  she  threw 
the  arms  about  and  also  the  ankles  of  both  feet.  The 
choreic  movements  involved  the  face  as  well  as  the  ex- 
tremities to  the  extent  that  it  was  with  great  difficulty 
that  the  child  could  drink  or  be  fed. 

The  treatment  consisted  of  long  applications  of  radiant 
light  and  heat  from  a  500  c.  p.  lamp,  over  the  front  and 
back  of  the  trunk  and  extremities  of  the  child,  until  well- 
marked  hyperemia  was  effected  particularly  marked  over 
the  trunk.  This  administration  required  practically  from 
forty-five  minutes  to  one  hour.  The  child  was  then  placed 
on  the  static  chair  lying  at  full  length  and  a  narrow 
electrode  was  placed  over  the  spine  extending  from  the 
sacrum  to  the  hair  line  on  the  back  of  the  neck.  Sheets 
were  placed  across  the  abdomen  and  extremities  and  tied 
beneath  the  chair,  to  hold  the  child  in  position.  If  the 
wave  current  is  administered  with  a  discharging  spark, 
the  noise  causes  an  increase  of  convulsive  movements  in 
these  patients.  Accordingly  the  current  was  administered 
with  the  terminal  balls  of  a  machine  having  sixteen  re- 
volving plates,  widely  separated  and  running  at  a  speed 
of  about  200  revolutions  per  minute,  for  twenty  minutes. 
Improvement  began  at  the  outset,  and  in  eight  days  the 
child,  whom  it  was  necessary  at  first  to  bring  in  a  cab, 


DISEAi!lES  OF  THE  NERVOUS  S\>*aM:M      1105 

was  able  to  coine  t(>  tlu'  ofticc  by  llie  surface  cars,  walking 
to  the  office,  and  in  tliree  weeks  was  discharged. 

In  addition  t<>  the  electrical  treatment,  cold  packs  were 
given  daily  for  the  first  wei'k  or  until  theiv  was  no  rise 
in  temperature,  when  hot  packs  were  substituted.  In 
three  weeks  this  child  was  practically  well,  and  has  re- 
mained s<)  for  one  year. 

She  had  been  on  the  use  of  Fowler's  solution  of  arsenic 
in  large  doses  from  the  first  appearance  of  the  symptoms, 
without  apparent  relief.  This  treatment  was  not  discon- 
tinued dnring  the  treatment  instituted  by  the  writer;  but 
the  promptness  with  which  the  sjinptoms  disappeared  as 
s<K)u  as  the  physical  treatment  was  begun,  in  a  case  which 
had  been  growing  progressively  worse  to  the  time  she 
ciune  under  observation,  was  evidence  of  the  etliciency  of 
the  method  of  treatment  adopted. 

The  theory  of  the  treatment  is  the  derivative  effect 
ami  increasi'd  nn'taliolism  and  elimination  induced  by 
applications  of  radiant  light  and  heat,  together  with  ef- 
fects of  the  static  current  upon  metabolism,  and  upon 
the  cord  condition.  The  regulation  of  diet,  which  should 
aJways  be  limited,  in  quantity  and  kind,  to  the  physical 
(bmiands  of  growth  and  nutrition,  by  controlling  the 
tendency  to  overfeeding  relieves  or  prevents  the  conse- 
quent auto-intoxication. 


CHAPTER  VI 

THERAPEUTICS  IN  NON-INFECTED  INFLAMMATION 

The  careful  consideration  of  the  principles  and  the 
modus  operandi  of  the  treatment  of  inflammation  is  given 
in  Chapter  II  of  this  section.  The  principles  employed 
in  the  treatment  of  every  non-infected  inflammation  is 
practically  the  same,  except  that  special  devices  or  elec- 
trodes are  employed  as  adapted  to  inflammatory  condi- 
tions of  the  varions  parts  of  the  body. 

The  resolution  of  stasis  or  the  dissolution  of  induration^ 
occurring  with  an  inflammatory  process,  as  previously 
stated,  is  the  indication  in  all  conditions  of  simple  in- 
flammation. This,  with  the  relief  of  resulting  symptoms 
of  muscular  tension  or  contraction,  and  the  restoration 
of  metabolism,  comprise  the  indications. 

The  author's  life  work  has  been  largely  identified  with 
the  investigation  and  promulgation  of  the  principles  of 
treating  inflammatory  processes  by  the  employment  of 
means  which  would  affect  the  resolution  of  induration 
always  present  with  inflammation,  and  the  cause  of  its 
persistence  except  where  infection  is  present.  This  has 
been  clearly  shown  in  numerous  monographs  and  works 
published,  and  verified  in;  the  experience  of  all  who  have 
recognized  the  principles  and  employed  them  intelligently. 
It  has  been  clearly  demonstrated  in  the  author's  experi- 
ence that  internal  or  external  applications  of  vibration 
or  massage  in  acute  inflammatory  processes  aggravates 

206 


THERAPEUTICS  IN   INFLAMMATION        207 

the  condition.  This  is  wi'll  iihisti-aUHl  by  the  failure 
from  the  treatment  of  sprains  and  intlamniati<>n  (tt  the 
prost-ate  gland  i»y  massage.  It  requires  a  <litrei\'nt  sort 
of  tissue  activity  than  that  transniitteil  by  vibration  or 
frioti(>n  to  effectually  relieve  local  stasis  or  infiltration 
when  once  established.  Those  measures  will  often  relieve 
the  resulting  muscular  tension,  thereby  affording  relief 
fioni  pressure  on  the  contiguous  joint  surfaces;  but  not 
the  induration. 

It  is  ihv  intrinsic  uctivity,  the  activity  of  the  parts  in- 
durated, piU'ticularly  the  diffuse  contraction  at  a  rate 
approximating  120  per  minute  alternating  with  periods  of 
release  or  rest  of  the  tissues  so  involved.  This  will  effect 
the  drainage  or  elimination  of  foreign  matter  from  the 
intercellular  spaces.  These  results  cannot  be  effected  by 
currents  which  stimulate  niu.scular  contraction  through 
stimulation  of  motor  points  as  is  done  with  the  consta,nt 
and  interrupted  current,  but  to  be  effective  require  direct 
applicatiim  to  the  mu.scle  cells  of  the  tis.sues  involved. 
As  has  been  .so  often  stated,  this  cannot  be  accomplished 
so  well  with  any  other  electric  current  ai>  with  the  high 
potential  static  modalities;  particularly  the  static  wave 
current,  the  static  sparks,  the  static  brush  discharge  and 
the  direct  vacuum  tube  current. 

These  modalities  induce  effects  which  have  never  been 
duplicated  nor  can  be  with  currents  of  low  jtotential  or 
the  currents  from  a  Ruhmkortf  coil  or  Tcsla  apparatus. 
In  other  word.s,  thv  tnntmvnt  of  uninjertvd  inflammation 
for  removing  infiltration  must  be  recognized  as  the  field 
of  the  static  currents;  currents  which  induce  diffuse  proto- 
plasmic contraction.  The  contractions  induced  by  other 
mmlalities  is  very  superficial  and  ineffective  as  compared 


208  HIGH-POTENTIAL  CURRENTS 

to  the  effects  of  the  static  modalities  which  can  be  regu- 
lated to  a  nicety  to  the  requirement  of  every  condition 
from  the  intense  or  powerful  effects  necessary  to  affect 
the  structures  of  the  hip  joint  and  gluteal  regions  to  the 
gentle  administrations  to  the  eye. 

The  results  obtained  by  the  institution  of  methods  of 
treatment  adopted  along  these  linevs  has  been  so  revolu- 
tionary that  medical  conservatism  is  alwiays  inclined  to 
doubt  the  possibility  of  the  things  accomplished  by  those 
who  employ  the  requisite  technique. 

Treatment  of  the  class  of  conditions  under  considera- 
tion, may  be  divided  into  (1)  the  types  of  arthritis,  (2) 
pelvic  inflammations,  (3)  congestions  and.  atony  of  the 
abdominal  organs,  and  (4)  other  inflammations,  neu- 
ritis having  been  treated  in  the  chapter  devoted  to  the 
diseases  of  the  nervous  system. 

A  sprained  ankle  offers  one  of  the  best  examples  for 
demonstrating  the  results  of  the  tireatment  and  of  the 
snccess  of  the  principles  of  treatment  under  considera- 
tion; because  here  we  have  to'  deal  with  conditions  not 
complicated  by  the  uncertain  elements  present  in  many 
types  of  arthritis.  The  following  case  will  illustrate  the 
facility  with  which  these  eases  are  treated  by  the  static 
currents. 

Mis«  W.,  a  student  of  Dr.  Savage's  Normal  School  of 
Physical  Education,  while  exercising  in  the  gymnasium, 
sustained  a  severe  sprain  of  the  right  ankle.  She  was 
referred  to  the  author  for  a  diagnosis  of  a  possible  frac- 
ture of  the  lower  end  of  the  fibula.  It  was  about  thirty- 
six  hours  after  the  accident ;  and  the  limb  was  very  much 
swollen  and  so  painful  on  movement  that  the  patient 
would  permit  no  manipulation  whatever.     The  x-ray  dis- 


THERAJPEUTICS  IN   INFLAMMATION        209 

closed  a  normal  condition  of  the  bones.  In  reply  to  the 
question  "  Is  thei-e  anythiuj;:  else  you  would  like  me  to 
do?  "  the  answer  was  made  by  the  accompanying^  pliysi- 
cian,  "  Wt'll,  what  tan  you  do?''  The  \NTiter  i>ei'sisted 
in  i-equt^tinj^  to  know  what  was  desircxl,  when  the  doctor 
said  they  \\ished  to  have  her  ready  for  active  eXiTcist^  in 
twenty  days.  \Vheu  the  author  replied  that  she  could  be 
ready  in  ten  days,  the  answer  came  "  Let  us  see  how  you 
do  it."  The  folloNNing  treatment  was  employed.  The 
patient  was  seated  upon  tlie  insulated  platform  and  soft 
met<il,  twenty-two  B.  and  S.  }j:auge  composition,  was  care- 
fully mouldixl  over  the  swollen  parts  of  the  foot,  and  the 
wave  current  administered  for  twenty  minutes.  Follow- 
ing this  the  static  brush  discharge  was  applied  over  the 
swollen  and  infiltrated  area,  wlien  the  doctor  remarked 
"  The  swi^lling  is  going  out."  The  whole  indurated  field 
became  softened  in  twenty  or  tliirty  minutes  application 
of  this  modality.  The  static  sparks  were  then  applied 
with  the  spark  director  below  and  around  the  internal 
and  external  mall<N>lus,  and  over  the  anterior  and  ])0S- 
terior  extensors  and  flexors  of  the  foot,  all  of  which  were 
in  a  state  of  tension. 

When  the  patient  came  into  the  office  ht-r  foot  was 
strappiHl  with  adhesive  strips.  Tiiese  were  removed  and 
not  replacefl.  The  patient  went  from  the  office,  an<l  down 
the  steps  with  the  crutches  in  her  hands,  an<l  said  iier  foot 
hurt  her  very  little.  The  next  day  she  returnetl  walking, 
but  with  her  crutches  in  her  hands,  lest  she  might  need 
them.  She  was  so  mucli  relievtnl  by  the  .second  treatment, 
that  the  following  day  she  returned  without  the  crutches, 
and  within  ten  days  she  wa.s  able  to  re,sume  her  usual 
gymnasium  work.    This  case  was  complicated  by  a  sciatic 


210  HIGH-POTENTIAL  CUREENTS 

neuritis  involving  the  nerve  both  at  the  saero^sciatic  notch 
and  in  the  popliteal  space,  the  result  of  the  fall.  These 
however  were  both  promptly  cured,  and  only  slightly  de- 
layed the  recovery  of  the  patient. 

Cases  of  sprains  which  come  under  observation  promptly 
after  the  accident  are  usually  cured  in  three  or  four  days 
by  the  method  described.  It  was  in  the  ti'^atment  of  a 
sprain  that  the  ^Titer  first  recognized  the  fact  that  stasis 
was  an  obstacle  to  be  overcome  for  which  nature  required 
assistance,  by  removal  in  order  to  facilitate  recovery. 
It  may  be  said  without  compromise,  that  all  sprains,  where 
no  severe  injury  has  taken  place  of  the  ligamentous  or 
bony  structures  of  the  joint,  are  promptly  cured  by  this 
method  without  rest  or  strapping.  The  same  principle 
applies  to  the  treatment  of  all  joint  inflammations. 

In  cases  in  which  there  are  indications  of  toxemia  or 
infection  associated  with  multiple  arthritis,  the  joint, 
lesions  though  symptomatic  demand  treatment  similar  to 
that  employed  in  the  treatment  of  the  sprained  ankle. 
The  main  reliance,  however,  in  the  treatment  of  chronic 
inflammation  of  the  large  and  small  joints,  are  the  static 
sparks,  directed  to  the  soft  structures  of  the  joint  avoid- 
ing direct  application  to  the  bony  points.  These  measures 
produce  diffuse  deep  contraction,  and  when  applied  suc- 
cessively to  the  infiltrated  tissue,  express  or  force  out  the 
accumulated  rubbish  from  the  lymph  spaces;  and  by  the 
removal  of  pressure  permit  the  restoration  of  circulation. 
It  may  be  said  that  there  is  in  addition  a  coincident  in- 
creased blood  supply  induced  by  the  stimulating  effect 
of  the  spark  discharge  as  well  as  removal  of  the  infiltrat- 
ing products  of  inflammation. 

The  application  of  sparks,  likewise,  to  the  tense  muscles 


TIlEKAPErTICS   IN    INFLAMMATION        211 

Avliich  are  constant l,v  i>r<'s<*nt  with  iiillaniniation  of  a  joint, 
adils  another  l>eneticial  factor  to  tlie  treatnient  of  the  joint, 
thereby  relieving  the  increased  im-ssure  in  tlie  joint  on 
movement.  Tills  tension  is  nature's  etl'ort  to  tix  the  joints 
and  thereby  prtKlnce  a  cure  l)y  anl<ylosis.  Nature's  metlio<l 
of  curiujjj  arthritis  is  ankylosis,  and  tlie  surj;eon  or  ortho- 
pedist who  employs  the  metluKl  of  rt^t  in  these  cases  is 
apt  to  make  the  Siiiuc  mistake.  In  no  class  of  ca.ses  is 
rest  more  contra-indicated  than  in  arthritis  except  of 
tubercular  joints,  when  ankylosis  in  the  late  cases  is  the 
only  probable  cure  of  the  condition. 

The  management  of  rhcumatoiil  tnthritis,  Still's  dis- 
ease, and  ostro-artJiriti.s:  The  treatment  of  the  joint  in- 
flammation is  of  first  imix>rtance;  but  in  oi-der  to  cure 
the  eases,  re<2;ulation  of  diet  to  the  requirements  of  the 
individual  for  the  correction  of  the  vicious  proi-esses  uni- 
formly present  in  thealimenfrary  canal  demands  coincident 
attention.  They  are  the  element  of  greatest  importance; 
because  they  constitute  the  exciting  causes  of  the  condi- 
tion. The  internist  however,  wIkj  attempts  to  cure  these 
cases  by  the  employment  of  <liet  for  correction  of  the 
intestinal  derangements  alone,  except  in  the  early  cases, 
will  meet  with  failure  f<»r  tiic  condition  of  arthritis  when 
once  established,  will  re(|nire  in  addition  tlu'  local  treat- 
ment described. 

Infectious  artliritis,  including  so-called  rheuniatisra, 
tubercular,  gonorrheal  and  septic  arthritis,  will  be  con- 
sidered in  the  chapter  on  the  treatment  (►f  infectious 
diseases. 

Pdi'ic  infianunutions:  t'onyrstinnx  of  the  )i')n-infr<-trd 
type,  include  the  congestions  a.^^sociated  witli  dysmen- 
orrhea, subinvolution,    ulcers    (»f    the    cervix,  caruncles, 


212  HIGH-POTENTIAL  CURRENTS 

ovarian  congestion,  prostatitis',  vesiculitis,  orchitis  and 
epididymitis.  These  affections  are  managed  with  remark- 
able facility  under  the  same  principles  of  treatment  as 
the  non-infected  inflammatory  conditions. 

Dysmenorrhea  and  subinvolution  are  in  a  large  per- 
centage of  eases  associated  with  retroversion  which  is 
the  natural  outcome  of  the  engorgement,  the  natural  sup- 
ports not  being  sufficient  to  keep  the  heavy  uterus  in  posi- 
tion. This  results  in  most  cases  in  constipation  and  the 
train  of  symptoms  and  conditions  associated  with  in- 
testinal putrefaction  and  auto-intoxication.  When  the 
retroversion  has  persisted  for  a  considerable  time,  the 
structures  of  the  round  ligaments  may  become  so  altered 
that  it  may  never  be  possible  to  restore  them  to  their 
normal  tone.  It  is  often  possible,  however,  after  removal 
of  the  congestion  and  weight  from  the  body  of  the  uterus 
for  it  to  remain  in  proper  position  without  the  aid  of  the 
normal  supports.  In  all  early  cases  however  the  normal 
tone  of  the  supports  seems  to  be  promptly  restored. 

The  remarkable  facility  with  which  these  uterine  con- 
gestions are  relieved,  must  be  witnessed  to  be  appreciated 
by  those  who  are  not  familiar  with  the  principle  of  action 
and  effects  of  the  method  employed;  because  the  results 
from  these  newer  methods  are  so  different  from  the  ex- 
perience \^dth  methods  with  which  most  physicians  are 
familiar.  This  method  has  been  employed  by  tlie  author 
since  it  was  discovered  by  him  in  the  way  described  in 
the  previous  chapter. 

Since  the  discovery,  it  has  been  our  practice  to  treat 
these  cases  per  rectum  and  with  uniformly  good  results. 
The  metal  electrode  is  placed  with  care  so  that  it  will 
come  in  contact  with  the  uterine  body  from  the  rectal  side 


THERAPEUTICS  IN   INFLAMMATION        213 

and  is»  held  in  ix>si(i(>n  by  the  pafcii'nt  or  with  an  x-ray 
tube  holdor  or  other  device;  the  patient  reclining  in  a 
comfortable  position  ui>ou  the  side  with  the  back  towards 
the  machine  or  in  Sim's  position.  The  wave  current  is 
reu:uJat4\l  as  in  other  cai>e^;  the  pain  pro<iuced  by  a  short  j 

spark-<^ap  bein*;  the  indication  of  the  presence  of  conjee*  j  i 

tion,  and  the  evidence  that  the  current  is  atTe^ctinrj  a  con- 
gested uteru*!;  for  if  normal,  it  would  not  caiLse  pain. 
Witii  the  gradual  lessening-  of  pain  due  to  the  ndie^f  of 
the  sui)erticial  intiltratiou  the  spark-gap  is  lengthcoied 
little  by  little  at  each  seance.  A  progivssive  improvement 
will  be  noted  as  in  other  cases  by  the  daily  incTeased 
length  of  spark-gap  which  the  patient  can  tolerate  from 
day  to  day.  The  treatments  are  administered  daily  for 
twenty  minutes  until  it  is  possible  U>  start  the  treatment 
with  the  spark-gap  of  three  inches  or  more;  after  which 
treatments  are  given  on  alternate  days,  until  within  a  few 
days  of  the  menstrual  period,  when  daily  treatments  should 
be  resmned  until  UK^nstruation  begins;  then  treatment 
should  be  discontinuwl.  If  menstruatiim  has  been  pain- 
less, treatments  may  cease,  or  otherwise  be  continued  as 
indicatt*d. 

The  prognosis  as  demonstrated  is  uniformly  good;  the 
only  eases  in  which  favorable  results  are  not  obtained  are 
those  of  acute  flexion,  or  mtual  stenosis.  The  usual  so- 
calkM.1  J^enosis  assoi'iated  with  dysmenorrhea  promi>tly 
disiippears  with  reli^'f  (»f  the  congt^stion  of  the  Ixxly  of  the 
uterus.  Actual  stenosis  is  probably  not  present  in  inoi>» 
than  one  to  five  per  cent,  of  cases  of  <lysmenorrhea;  at 
least,  that  is  according  to  the  findings  of  the  author. 

^Vh€n  endometritis  compUcntrs  thr  condition,  the  syste- 
matic €*mployment  by  the  metJKKl  of  l)r.  Ma.ssey,  by  the 


214 


HIGH-POTENTIAL  CURRENTS 


intra-u'teriue  application  of  the  positive  pole  of  the  con- 
stant current  with  an  amalgamated  copper  electrode  is 
indicated,  applying  it  with  from  ten  to  twenty  milliamperes 
of  current  for  from  ten  to  twenty  mriintes.  This  method 
is  employed  for  the  purpose  of  destroying  the  unhealthy 
endometrium.     By  this  method  tlie  electrical  diffusion  of 


Fig.  47.     Common  Metal  Eeetal   Electrode. 

the  mercury  and  copper  salts  into  the  lining  membrane 
causes  it  to  slough  away,  to  be  replaced  by  a  healthy  mem- 
brane. This  treatment  should  be  employed  but  once  and 
carefully  guarded  as  to  dosage,  so  as  not  to  create  too 
extensive  destruction  of  the  endometrium,  and  should  be 
followed  by  the  systemiatic  rectal  employment  of  the  static 
current  as  previonsly  described. 


Fir„  48.     Author's  Eeetal  Electrode. 


Uterine  subinvolution  is  treated  in  practically  the  same 
manner,  but  will  often  be  effectually  cured  in  from  five 
to  ten  seances.  In  this  class  of  cases  no  other  condition 
responds  so  promptly  and  effectively  to  this  method  as 
the  cases  of  subinvolution.  They  are,  however,  more  apt 
to  suffer  from  the  derangements  of  the  endometrium,  and 
require  intra-uterine  treatment  than  the  cases  of  simple 
dysmenorrhea. 


TIIKKAl'ErTICS   IN    I  N  TLA.M  M  ATK  )N 


I'l.') 


The  usual  <h  (troth's  (mii]»1(iv('(1  in  these  oases  in  wliieh 
rectal  ti^'atiuciit  is  inilicate<l,  is  the  eommon  straij^Iit 
electr(Kl<'  slit»\vn  in  I'i^.  47,  or  the  antlior's  electrixle  ali^o 
emplovfHl  in  tin*  tnMtnn'nt  of  |n-(istutitis.  sJliown  in  I-'ii;. 
48,  anil  an  cIccii-tMle  desijjncd  Ity  I)i-.  Ai-n<»l<l  Snow  wliich 


Fi(i.  49.     «"urvetl  Electrode  Designed  by  Dr.  ArnoM  Snow. 

is  i'urvetl  a.s  shown  in  Fii;.  4!).  Tliese  electiixles  have  each 
their  special  imlication  and  are  designed  t'o  give  as  certain 
contact  as  possible  with   tlx'  i)aits  tr('at<'d. 

In  cases  of  subinvolution  or  dvsnicnoirhea,  complicated 


r  M/icHi  "rr    5jj< 


I  i    .    jO.     (.ilass   Vajjinsil   Vjicmun    Hlpctrti'lo. 

by  cervical  ulcerations  or  an  ('d«*niatons  condition  of  ihe 
cenix,  it  is  best  to  employ  with  each  s<'ance  an  a<lditional 
fifteen  minutes  applicatiim  with  th<'  direct  vacuum  tube 
current  Avith  a  two  to  f<Mir  inch  spark-gap  <'mplo\ing  the 
glass  vaginal  vacuum  eIectr<Ml<'  shown  in   I'ig.  .~n.     These 


216  HIGH-POTENTIAL  CURRENTS 

electrodes  are  made  in  various  sizes,  and  when  used  as 
described,  the  results  of  treatment  are  satisfactory. 

Urethral  caruncles  are  treated  in  practically  the  same 
manner,  employing  a  glass  (Fig.  51)  or  metal  urethral 
electrode  of  a  size  which  will  cause  a  moderate  degree  of 
dilatation  employing  the  direct  vacuum  tube  current  or 
the  wave  current.  Many  of  these  cases  will  be  promptly 
cured  by  this  method.  Others  in  which  there  is  a  growth 
of  hyperplastic  tissue,  will  resist  treatment,  though  in 
most  cases  the  symptoms  are  very  much  relieved. 

In  cases  of  marked  vesical  irritation  the  treatment 
with  a  metal  electrode  placed  just  above  the  pubes  affords 


Fig.  51.    Glass  Urethral  Electrodes. 

prompt  and  remarkable  relief  in  a  large  percentage  of 
cases. 

In  ovarian  congestions  the  symptoms  of  pain,  often 
designated  as  ovarian  neuralgia,  are  usually  promptly 
cured  with  the  relief  of  a  subinvolution  or  dysmenorrhea 
which  is  apt  to  be  the  cause.  In  some  eases,  however,  the 
pain  may  persist,  indicating  persistence  of  congestion.  In 
these  cases,  the  application  of  the  static  wave  current  with 
a  metal  electrode  directly  over  the  offending  organ  will 


TIIEKAPErTICS  IN   INFLAMMATION        217 

in  all  i'a>H»s  <»f  sinipk'  intlaniinatiuii  I'llVct  the  relief  of  the 
eongeifttion.  The  operator  should  be  certain  to  (lia*!:nose 
an  infection  before  employing  the  wave  current  lest  it  be 
scatteretl. 

Vdffinisnnts  is  usually  promptly  cured  by  s\'steniatically 
pa.*<siiig  into  the  vagina  vacuum  tubes  a»s  large  as  will 
n*adily  pa.ss  emi)loying  each  subsequent  day  a  larger  tube 
an<l  employing  the  direc-t  vacuum  tube  current  with  a  two 
to  four  inch  si)ark-gap. 

Prostatitis  as  treated  by  the  authors  meth<Kl,  has  open-'d 
a  way  to  the  relief  and  cure  of  one  of  the  most  distressing 
conditions  of  the  male  sex. 

Inflammation  of  the  prostate  gland,  or  prostatic  hyper- 
trophic s<vcalbHl,  arises  from  numerous  causes;  aud  cannot 
be  attributtnl  to  anything  vicious  in  the  life  of  the  indi- 
vidual, tbougli  gonori'hea  is  undoubtedly  the  most  pro- 
lific cause.  Bruises  upon  the  perineum,  as  obtained  in 
hoi-seback  riding  and  bicycle  riding,  and  other  mechanical 
effects,  contribute  to  the  early  institution  of  an  inflaiimia- 
toi*}'  process  and  as  in  other  inactive  sites,  the  intlamma- 
toiy  proc'ess  is  prone  to  increase,  enlarging  the  indurated 
area.  In  prostatitis  the  inflammatory  procc^.s  onoe  begun, 
is  disj>ose<l  to  greatly  increa-se.  Occasionally  a  neoplasm 
or  tibroid  tissue  devel<)]»s  in  a  gland.  This  c(mdition  liow- 
ever  has  be<*n  f<Kind  but  infivqm'ntly.  In  a  previous  mouo- 
gi~aph  the  writer  stated  that  hyperx)la8ia  was  probably 
often  present  in  these  cases,  and  would  prevent  a  rtMluc- 
tion  of  the  gland  to  normal.  More  ri'Ci'ntly,  however,  it 
seem.s  to  have  In^en  demonstrated  in  the  author's  exjx'ri- 
ence  that  by  persistent  treatment,  even  in  old  men,  the 
glamls  may  be  generally  reduce<l  to  normal  with  com- 
plete reduction  after  two  or  three  niontlis  of  static  treat- 


218  HIGH-POTENTIAL  CURRENTS 

ment.  These  cases  do  not  include  the  fibroma,  of  which 
the  author  has  diagnosed  but  three  in  upwards  of  150 
cases. 

The  prognosis  in  prostatitis,  based  upon  the  author's 
results  by  this  method  is  uniformly  good  except  in  tuber- 
cular or  malignant  cases.  In  cases  in  which  a  fibroma 
is  present,  the  relief  is  marked,  though  not  complete,  aud 
in  these  cases  the  Roentgen  ray  is  indicated  as  an  adjunct 
to  the  static  treatment.  Malignant  or  tubercular  prostati- 
tis ^ill  be  considered  in  the  next  chapter. 

The  method  employed  is  practically  as  follows:  The 
patient  is  placed  upon  the  chair,  lying  upon  the  side,  with 
the  back  to  the  machine  as  shown  in  Plate  V.  The  elec- 
trodes shown  in  Figs.  47  or  48,  are  either  held  in  position 
by  the  hand  of  the  patient,  or  by  an  x-ray  tube  holder  as 
shown.  Care  must  be  taken  that  the  electrode  is  well  in 
contact  with  the  gland,  and  in  the  median  line.  If  lying 
laterally,  or  placed  at  an  angle  Avhich  will  reach  the  great 
nerve  trunks  in  the  pelvis,  on  eitlier  side,  pain  mil  be 
induced  down  the  course  of  the  corresponding  nerve,  which 
will  indicate  its  position  away  from  the  median  line.  In; 
other  cases  in  which  the  electrode  is  placed  too  high  in 
the  rectum,  the  parts  will  be  found  very  sensitive  at  the 
extremity.  Care  f^hould  be  taken  to  place  it  just  far  enough 
into  the  rectum  not  to  cause  pain  other  than  from  pressure 
upon  the  gland  itself.  In  cases,  when  the  electrode  is 
applied  directly  to  the  vesicles,  and  the  current  is  given 
rather  strong,  a  disagreeable  pain  may  be  induced  in  the 
testicles,  which  may  remain  for  several  hours.  This  is 
promptly  relieved,  however,  by  the  application  of  radiant 
lig-ht  and  heat. 

The  rate  at  which  the  spark-gap  is  allowed  to  discharge 


w 


in 

•3 


in 
to 

s 


•i 


THEHAPEUTICS   IN    INFLAMMATION        219 

is  one  of  tlu>  uu>st  important  ix)in'ts  in  the  tccliniqiie  of 
tiiis  iiictlnMJ  of  t ri-iitment.  If  the  spark-uap  is  (lisclmrgiiig 
at  a  rate  above  300  jxt  ininiito,  a  disaji^'eeable  pain  is 
apt  to  be  prodiu-tMl  due  to  an  intiMisc  ronti-actioii  of  the 
parts.  The  rate  of  spark-di.scharjj^e  therefore  should  not 
exceed  300  per  minute  and  120  is  to  be  preferreil.  This 
can  only  he  rcucuhited  by  a  means  of  very  uniform  speed 
contiMjl;  one  whicli  will  i>ermit  of  very  gradual  increase 
of  s]hhh1.  With  each  increase  of  the  length  of  the  spark- 
gap,  the  si>eed  (►f  the  machine  must  naturally  be  relatively 
increased.  If  the  resistance  steps,  in  the  rheostat  of  the 
direct  cuiTent  motor  give  too  great  variation,  it  is  im- 
possible often  to  regulate  the  rate  of  discharge  except 
some  other  device  In?  provided,  which  slumld  l>e  unneces- 
sary because  with  the  direct  current,  in  a  properly  graded 
rheostat  the  control  should  be  perfect. 

If  the  power,  however,  is  derived  from  the  alternating 
current,  a  mechanical  speed  control  is  the  only,  at  present, 
practical  means  of  regulating  the  rate  of  discharge  for 
the  properly  delicate  management  of  these  cases,  because 
it  is  impo.s.s(il)le  to  regulate  the  alternating  current  by  any 
present  device  to  sufficiently  delicat^i  changes  of  speed. 
The  size  of  the  tenninal  balls  of  the  discharging  nxls, 
should  not  l>e  larger  than  one  and  one-fourth  inches  in 
diameter;  because,  otherwise  the  contractions  of  the  gland 
will  Im'  too  \iolrnt. 

It  will  be  found  in  some  cases  that  after  several  days 
of  daily  tn'atnu'ut  the  patient  will  feid  a  degree  of  sore- 
ness following  the  administration,  due  to  over  stimulation 
of  tlu'  gland  l»y  the  active  gymnastics  induci^l  in  it  by  the 
current.  In  the.se  caaes  the  treatment  should  be  slightly 
shortened,  or  the  author  has  found  that   the  administra- 


220  HIGH-POTENTIAL  CURRENTS 

tion  of  tlhe  current  is  less  stimulating  through  the  medium 
of  a  glass  vacuum  electrode  employing  the  direct  yacuum 
tube  current,  by  the  same  arrangement  as  for  the  wave 
current  with  an  electrode  similar  to  the  one  illustrated 
in  Fig.  52.  Improvement  will  be  indicated  by  the  increased 
length  of  spark-gap  that  the  patient  will  permit  at  the 
outset  of  the  treatment  from  day  to  da^^ — the  longer  spark- 
gap  indicating  the  progress  made  in  the  relief  of  the  condi- 
tion. When  it  is  possible  for  the  patient  to  bear  a  four 
inch  spark-gap  at  the  outset,  as  long  as  will  ever  be  re- 
quired, treatments  may  be  given  on  alternate  days  until 
the  gland  is  reduced  to  a  normal  size.  The  marked  relief 
afforded  by  the  first  few  treatments  in  the  cases  of  large 


Fig.  52.     Long  Rectal  Electrode. 

infiltrated  prostates  is  remarkable.  Usually  mthin  the 
first  week  the  frequent  micturation  is  relieved  and  much 
of  the  bladder  tone  restored.  The  majority  of  cases  are 
permanently  relieved  within  a  month,  though  with  some 
patients,  in  which  the  eonditioin  is  of  long  standing,  it 
is  a  good  policy  to  continue  the  treatments  for  two  or 
three  months  with  a  view  of  reducing  the  gland  to  the 
normal  size,  which  can  often  be  accomplisihed  and  is  desir- 
able in  all  cases,  thereby  forestalling  the  possibility  of 
relapse. 

This  effect  upon  the  prostate  gland  was  d/iscovered  by 
the  writer  when  treating  an  intra-pelvic  neuritis  in  which 
a  large  tender  prostate  was  diseoveretd;  and  it  was  noted 


TUERAPEUTTCS  IN  INFLAMMATION        321 

following;  the  luliiiiiiistratioii  that  t.lie  gkuid  was  very 
much  soft^^ned  and  ivduciil  in  size.  It  "vvas  more  tluon  a 
year  aftiT  this  effect  was  noted  l)efor<'  it  was  brought  into 
service;  when  the  following  case  came  under  observation 
besei'ching  the  A\Titer  t-o  relieve  him  from  liis  great  sutTer- 
ing  lH>th  mental  and  physit-al. 

Mr.  O.,  aged  sixty-three,  began  treatment  June  15,  1901, 
in  a  state  of  great  depression.  He  stated  that  for  four 
years  he  had  been  obliged  to  rise  several  times  each  night 
to  void  his  urine,  passage  becoming  gradually  more  diffi- 
cult and  more  frequent;  and  during  the  pixivious  weeka 
the  odor  of  the  urine  had  become  very  oifensive.  He  had 
also  been  unable  to  retire  at  all  at  night  on  account  of 
the  necessity  of  continually  rising  (►wing  to  the  vesical 
in-itation.  Examination  of  the  urin<'  sliowed  the  reaction 
to  be  alkaline,  very  offensive,  and  to  contain  quantities  of 
mucus  as  well  as  numerous  pus  cells.  The  treatment 
emj)ioye<l  was  the  daily  administration  of  the  sUitic  wave 
cum'ut  with  a  straight  met^il  electrmle  a  cut  of  which  is 
shown  in  Fig.  47,  for  twenty  minutes  daily.  At  tlie  first 
treatment  the  pain  caused  by  the  contraction  induced  waa 
80  severe  that  a  current  measured  by  a  one  inch  spark-gap 
was  all  that  could  be  employed.  At  the  close  of  the  treiit- 
ment  however,  the  spark-gap  had  bc^n  graduaJly  length- 
ened to  about  four  inches.  The  patient's  gr«it  sense  of 
relief  after  the  first  treatment  was  remarked.  After  four 
daily  administrations  the  patient  was  voiding  urine  with 
greater  free^hum  and  much  less  fr<'(|u<'n11y,  and  the  char- 
acter of  the  urine  was  less  irriUiting  and  continued  h'3S 
precipitate.  These  treatments  were  c<)ntimie<l  daily  for 
two  weeks,  ami  (m  alternate  days  for  one  \v«'<'k  longer, 
when   the  patient's  condition   was  s^»   far   improved   that 


222  HIGH-POTENTIAL  CURRENTS 

he  was  mot  obliged  to  rise  at  night  nor  to  void  urine  during 
the  day  too  frequently,  and  treatment  was  discontinued. 
No  other  treatment  was  employed  with  the  static  wave 
current,  except  the  administrations  of  vesical  antiseptics. 
It  is  now  more  thian  nine  years  since  this  patient  was 
treated,  and  there  has  been  nio  return  whatever  of  the 
symptoms;  and  he  has  not  been  obliged  to  rise  nights  to 
void  urine,  as  it  had  been  Ms  habit  with  increasing  annoy- 
ance for  more  than  four  years  preceding  the  treatment. 

The  results  of  treatment  in  this  case  aroused  the  w^riter 
to  the  importance  and  remarkable  possibilities  of  this 
method  of  treatment,  whidh  has  been  followed  by  the  suc- 


FiG.   53.     Concave  Faced  Vacuum  Electrode. 

cessful  treatment  of  upwards  of  140  cases  since  the  cure 
of  this  first  case ;  and  the  percentage  of  relapses  has  been 
very  slight;  and  these  cases  have  been  promptly  cured 
a/nid  remain  permanently  well. 

No  work  during  recent  years  has  given  the  author 
greater  satisfaction  than  the  treatment  of  these  unfor- 
tunate patients;  and  the  cordial  support  that  h'as  been 
accorded  the  method  and  the  grateful  expressions  of  ap- 
preciation by  the  members  of  the  medical  profession  who 
have  become  familiar  with  the  method,  has  amply  re- 
warded the  author  for  the  years  of  labor  that  he  has 
devoted  to  the  development  and  advancement  of  improved 
therapeutic  methods. 


THEKAPEUTICS   IX   INFLAMMATION        223 

In  vesiculitis  caiv  should  ho  takou  to  carry  the  electrode 
hi<:fh  euouj^h  and  far  ciKHiiih  forward  to  imi)iiij;e  uimhi  the 
affected  vesicles.  It  is  also  ix>s.sible  in  these  cases  as  in 
prostatitis  t<>  cHVct  a  iioriiial  condition  (►f  the  parts. 

///  orchitis  apply  the  pn^pcr  vacuum  electrode,  either 
the  usual  surface  electrode,  or  one  havinfj  a  concave  face 
as  slunvn  in  Fi.u:,  53,  holding;  it  first  over  the  upper  iH)rtion 
of  tlu*  lihunl,  anil  g^radaially  as  the  parts  are  softened 
passinj;  it  further  down,  until  the  tenderneas  and  indura- 
tion are  rclievtHl.  It  is  surprisiuii;  how  efTtx^tive  this 
metlKxl  is  in  relieving  this  distressing  condition.  A  gland 
which  is  so  sensitive  that  it  cannot  Ix*  nianipulat^nl  prior 
to  treatment  is  soft  and  painless  on  manipulation  follow- 
ing a  twenty  minutes  to  half  hour  administration  of  the 
current.  The  spark-gap  in  this  as  in  all  othi^r  cases  should 
be  regulatiHl  to  the  toleration  of  the  patient. 

In  epididymitis  the  modus  operandi  is  exactly  the  same 
and  the  relief  is  prompt  and  certain,  employing  the  same 
electrodes  as  in  orchitis. 

In  varicocele  the  indication  is  to  relax  the  muscular 
tension  of  the  internal  and  external  ring  or  the  canal 
"w'here  pressure  upon  the  spermatic  cord  and  veins  is  inter- 
fering with  th<'  venous  retm-n.  The  author's  method  of 
treating  these  ciisi\s  is  either  to  hold  the  convex  surface 
of  the  rectal  electrode  shown  in  Fig.  48,  or  a  piece  of 
metal  bent  so  that  the  curve  will  conform  with  the  sur- 
face over  the  canal,  held  in  iMtsition  with  a  towel  in  the 
patient's  hands.  Owing  to  the  pubic  hairs  it  may  be 
nece.Msjirv  to  thoi"oughly  moisten  the  parts  to  avoid  the 
unpleasant  stinging  of  the  short  sparks,  Uy  this  means 
the  muscular  contractions  are  relaxed,  and  the  obstruc- 
tions to  return  circulation  through  the  vein   is  removed. 


224  HIGH-POTENTIAL  CURRENTS 

In  the  €arly  cases,  before  the  vein  is  materially  occluded, 
the  effect  is  prompt  and  the  cure  complete. 

In  a  physician,  while  under  treatment  for  prostatitis, 
a  varicocele  coincidently  disappeared  as  reported  by 
him.  This  case  had  been  undeir  treatment  for  prostatitis 
in  the  office  of  one  of  the  best  specialists  in  this  city,  by 
m(assage  without  relief,  and  with  a  loss  of  ten  pounds  in 
weight  immediately  before  he  came  under  observation. 
After  three  weeks  the  condition  was  cured  by  the  author's 
method,  as  previously  described,  and  the  variococele  had 
also  disappeared,  and  he  had  regained  the  weight  lost 
dniring  the  process  of  massage  and  was  also  relieved  of  a 
profound  condition  of  neurasthenia. 

Congestion  and  atony  of  abdominal  organs.  The  effects 
of  the  static  current  upon  congestion  in  the  abdominal 
cavity,  are  the  same  as  in  other  simple  congestions;  the 
induction  of  successive  contraction  of  the  respective  vis^ 
cera,  effects  the  elimination  of  infiltration  and  exudation 
with  the  restoration  of  the  circulation  and  function  of 
the  parts. 

Malignant  disease^  tuberculosis  of  the  viscera  and  other 
infectious  processes  are  always  to  be  considered  in  the 
treatment  by  the  wave  current  and  static  modalities  of 
abdominal  congestions;  for  in  any  of  these  affections  the 
application  of  these  modalities  are  contra-indicated  and 
their  presentee  may  often  be  determined  by  aggravation 
of  the  symptoms  from  the  effects  produced  by  one  or  two 
treatments  when  little  or  no  harm  may  be  induced  except 
in  pus  processes  which  should  always  be  excluded  before 
the  wave  current  is  applied.  The  age,  history  and  con- 
dition of  the  patient  at  the  time  will  generally  assist  in 
excluding  these  conditions. 


THERA1*EUTI€S  IN  INFLAMMATION        225 

In  paj'CncJu/matoiis  and  interstitial  7iei)hriti.s  the  iudi- 
cations  are  practically  the  stmie.  The  static  wave  curi'eut 
should  be  administered  directly  over  the  kidneys,  as  de- 
scribcMi  in  a  preceding  chapter.  The  daily  application  of 
an  electrode  six  by  eight  inches  over  tins  region  and 
employing  a  slowly  discharging  spark-gap  of  eight  or  tea 
inches  for  twenty  minutes  will  be  remarkably  cffiHi-tive  in 
relieving  the  congestion  mid  infiltration  of  an  inflamed 
kidney,  the  seat  of  either  type  of  nephritis. 

Ili/pcrtrophic  cirrhosis  of  the  liver  can  be  very  rapidly 
reduced,  and  the  accompanying  symptoms  relieved,  by 
the  application  of  the  wave  current  with  an  electrode 
over  the  area  of  congestion.  If  these  patients  will  dis- 
continue the  use  of  alcohol,  and  persist  in  the  treatment, 
the  prognasis  as  to  recovery  is  excellent  if  instituted  early 
in  the  case  and  beneficial  in  all  cases. 

Enlargement  of  the  spleen  of  malarial  origin  is  fre- 
quently found  in  patients  living  in  the  tropics.  Dr.  Con- 
diet  has  demonstrated  beyond  question  the  efficiency  of 
the  wave  cuiTent  in  reducing  the  enlarged  spleen  in  these 
casi'S,  and  i-estoring  the  patients  to  health.  In  these,  as 
in  cirrhosis  of  the  liver,  a  large  plate  should  l>e  applied 
over  the  enlarged  spleen,  and  the  spark-gap  emploj-ed 
should  be  long  tmough  to  cause  mark(id  contraction  of  the 
abdominal  walls  and  underlying  organs.  It  is  very  ques- 
tionable whether  the  wuve  curi-ent  should  be  employed  in 
cases  of  leukemia,  partaking  so  much  of  the  characteristics 
of  malignancy. 

In  diabetes  melUtus,  the  results  are  remarkable  in  the 
cases  in  which  the  b'sion  is  of  pancreatic  origin  from  the 
admini.^^-t ration  of  the  static  wave  current  with  a  soft  metal 
electrode  over  the  epigastrium.    Cures  have  been  effected 


226  HIGH-POTENTIAL  CUKRENTS 

by  such  employment  of  the  measure.  When,  however,  a 
high  blood  pressure  is  complicating  the  condiition,  it  would 
seem  to  be  the  cause;  because  the  employment  of  auto- 
^ondensation  only  has  often  effected  complete  disappear- 
ance of  the  glycosuria  during  the  course  of  treatment. 

Dr.  de  Kraft's  method  by  employing  the  pulsatory  reson- 
ator discharges  over  the  abdomen  and  body  of  the  patient 
has  been  reported  by  him  to  be  remarkably  efficient  in 
diabetes  mellitus. 

Atonic  conditions,  which  often  result  in  congestions 
owing  to  engorgement  and  defective  metabolism,  are  re- 
lieved by  the  static  wave  current,  radiant  light  and  heat, 
and  the  d'Arsonval  current  by  the  direct  method  either 
alone  or  in  combination.  In  these  cases  the  wave  current 
should  be  administered  with  a  large  abdominal  electrode 
and  a  slowly  discharging  spark-gap ;  the  rate  not  to  exceed 
120  per  minute,  and  to  be  long  enough  to  produce  suc- 
cessive contractions  of  the  abdominal  contents. 

Relaxed  abdominal  walls,  as  present  in  debilitated 
patients,  are  restored  to  normal  by  this  method  of  treat- 
ment. 

Gastric  and  intestinal  atony  with  impaired  function  of 
the  excretory  and  secretory  functions  of  the  alimentary 
canal,  with  the  comsequent  constipation,  are  remarkably 
benefited  by  applications  of  the  static  wave  current  in 
the  manner  above  described. 

In  constipated  children  and  young  adults  no  other  treat- 
ment is  necessary  to  relieve  the  condition,  though  it  is 
customary  in  these  patients  to  also  employ  mechanical 
vibration  and  radiant  liglit  and  heat.  The  same  methods 
should  be  employed  in  the  treatment  of  all  cases  of  con- 


TIIEHAPEUTICS  IN  INFLAMMATION        227 

stipation,  anmsiiii;  as  it  (1(k\s  to  activity  tlu'  imisculature 
and  soc-iH'tory  fiiiutions  of  the  aliiiii'iitary  canal. 

In  chronic  piciirisi/  irith  adhcsionfi,  excellent  results 
have  been  rei>oi-te<l  from  the  application  of  the  static  wave 
current  over  the  chest  wall.  In  the.'-ie  cases  it  is  iniiw>ssihle 
to  use  so  lonjj:  a  spark-<;ap  as  is  employed  over  the  ab- 
dominal ca\ity,  and  in  all  eases  it  sh<)uld  be  rej^ulated 
so  as  not  to  cause  too  great  disci>mfort  to  the  patient. 

In  other  congestions  of  the  simple  intlamniatx)ry  class, 
wherever  fouml,  the  static  current  is  indicated  as  in  num- 
erous ciises  to  be  mentioneil,  employing  them  in  accord- 
ance with  the  general  principles  of  dosage. 

Phlebitis,  has  received  ineffective  treatment  in  the  past, 
as  is  evidenced  by  the  number  of  patients  who  ai)pear  with 
varicose  veins.  The  treatment  of  a  phlebitis  by  wet  dress- 
ing witii  elevation  and  rest  is  most  impractical ;  for  these 
methods  favor  the  process,  fibrinous  adhesions  developing 
an  eventuiil  complete  occlusion  of  the  vein. 

The  indication  here  as  in  all  inflammatory  conditions  is 
to  relieve  the  infiltration  and  congestion  of  the  involved 
vein. 

The  treatment  is  best  effected  by  the  application  of  the 
static  bru.sh  discharge;  f<>r  in  these  cases  of  superficial 
phlebitis,  there  is  n<>  <K-casi<>n  to  employ  the  wave  current 
or  sjKirks.  Furthermore,  it  is  unwise  to  employ  the  wave 
current  in  these  cases  lest  by  too  vigorous  action  an 
embolus  might  under  some  conditi<ms  be  <liskxlgcd,  which 
would  not  happen  by  the  gentl<*r  application  of  the  static 
brush  dis<-jiarge  which  is  fully  as  effective.  It  is  the 
author'.s  practice  1<>  employ  first  radiant  light  and  heat 
over  the  affecte<l  arcn,  and  then  to  fnllow  with  the  applica- 
tion of  the  static  brush  discharge  in  cases  of  acute  phlebitis 


228  HIGH-POTENTIAL  CURRENTS 

until  the  indurated  tissues  are  thoroughly  softened.  The 
limb  should  be  bandaged  in  the  intervals  between  treat- 
ment with  some  flexible  material  that  will  sustain  and 
support  the  part,  and  prevent  swelling  of  the  parts  below 
the  obstruction,  if  the  vein  is  partly  occluded. 

In  chronic  phlebitis  the  same  treatment  should  be  em- 
ployed, and  the  prognosis  is  relative  to  the  time  that  the 
process  has  been  present;  for  here  as  in  all  cases  of  infil- 
tration, the  organized  exudation  as  previously  stated  will 
produce  occlusion  of  the  vein.  It  is  very  ofteu  possible 
to  restore  the  circulation  in  cases  by  this  method  of  a 
year's  standing  by  persistent  application  wdth  radiant  light 
and  heat  aud  the  static  brush  discharge.  The  author's 
success  in  these  cases  by  the  method  desscribed  has  been 
most  gratifying. 

Varicose  ulcers,  result  in  most  cases  from,  an  uncured 
phjlebitis  with  occlusion  of  the  vein.  They  are  so  often 
intractible  by  other  means;  but  are  promptly  cured  except 
in  old  and  long  standing  cases,  when  a  longer  time  is  re- 
quired. The  ultimate  result  will  be  successful  by  the 
use  of  radiant  light  and  the  static  brush  disc'harge.  Majuy 
of  the  milder  cases  may  be  cured  by  radiant  light  and 
hieat  alone  but  it  will  require  a  much  longer  time  than 
the  application  of  the  static  brush  discharge,  because  by 
the  static  brush  discharge  the  induration  surrounding  the 
ulcer  is  promptly  removed;  and  the  circulation  re-estab- 
lished to  the  margin,  which,  together  with  the  stimulation 
of  the  tissues,  promotes  rapid  granulation  and  healing 
of  the  ulcer.  This  will  be  the  result  in  the  treatment  of 
ulcers  uot  of  malignant  origin.  The  author  has  success- 
fully treated  lupus  ulcers  by  the  same  method  but  as  a 
rule  the  x-ray  should  precede  the  brush  discharge  in  lupus. 


THERAPEUTICS  IN  INFLAMMATION        229 

In  the  treatmont  of  ulcers  whore  much  oedema  is  pre-sent, 
the  hiiish  discharge  should  be  applied  over  the  whole  in- 
filtrated area  until  it  is  softened;  after  which  the  ulcer 
should  be  dressed,  and  the  limb  bandaj^ed  from  the 
extremity  to  the  parts  above  the  ulcer.  The  progmosis 
in  these  cases  is  always  gO(xl ;  and  the  promptness  with 
which  they  are  cured  is  relative  to  the  chrouicity  and  ex- 
tent of  the  lesion. 

Ulcers  of  the  cornea  and  eyeball  may  in  most  caseis  be 


Fig.  54.     Vacuum  Eye  Electrodes,  Single  and  Double. 

cured  either  by  the  application  of  the  static  brush  dis- 
charge over  the  eyelid,  or  the  use  of  the  vacuum  electiH)de 
(Fig.  54,  single  and  double  eye  electrode),  appli<Ni  over  the 
eyelid,  for  ten  or  tifteen  minutes  daily,  employing  a  spark- 
gap  that  will  produce  sensible,  not  i)ainful  vibration  of 
the  eyeball.  These  cases,  as  all  inflammatory  conditions, 
should  have  daily  treatment  until  tlie  condition  has  dis- 
apfM';i.i"ed. 

I*tcnj(jium  in  the  wirly  st<ig(NS  may  be  promi)tly  cured 
by  the  same  method  of  treatment  as  that  employed  for 
the  treatment  4>f  corneal   ulcers.     It  is  remarkable  how 


230 


HIGH-POTENTIAL  CUKEE-NTS 


promptly  these  dilated  vessels  contract  and  disappear  in 
early  cases.  "* 

Congestion  or  ohstriwtion  of  the  tear  ducts,  when  sten- 
osis has  not  already  occurred  by  adhesion  of  tihe  adjacent 
walls  of  the  canal,  are  promptly  cured  by  the  direct  vacuum 
tube  current  through  the  medium  of  any  vacuum  electrode 
which  will  cover  the  course  of  the  canal.  The  promptness 
with  which  this  condition  is  relieved  is  most  gratifying 
compared  with  the  method  by  dilatation  and  probing. 


■:~^-mm;mk 


Fig.  55.     Variously  Curved  Vacuum  Tubes  for  Nasal  Treatmeut. 


Glaucoma  in  the  early  stages  may  be  greatly  benefited 
if  not  arrested,  by  the  application  of  radiant  light  and 
the  direct  vacuum  tube  current  to  the  eyeball.  The  ten- 
sion is  promptly  relieved,  and  the  condition  if  kept  under 
cl^se  observation  is  arrested.  This  has  been  accomplished 
in  the  case  of  a  lady  physician  under  observation  by  the 
author  for  about  two  and  a  half  years,  the  field  of  vision 
having  been  greatly  enlarged,  and  the  tension  of  the  eye- 
ball is  now  absolutely  normal.  The  case  was  diagnosed 
by  Dr.  Valk  of  New  York,  and  ihas  been  under  observa- 


THEKAPEUTICS   iX    IM  LAMMATIUN        231 

tion  of  Dr.  Ri-<»u<;lit(>n  also  of  Now  York,  for  inon*  than 
two  years,  wiiile  under  treatnuint  by  the  author. 

Congefftiouft  of  the  na.wl  passages  are  remarkably  re- 
lieved and  the  passages  made  free  by  removal  of  the  iu- 
filtratioii  by  the  direct  vacuum  tube  current.  The 
electrodes  empbiyed  are  the  tlat  nasal  and  the  curv(Kl  iias;il 
shown  ill  Fiiis.  .")■>  aiul  .")<).  The  administrations  are  made 
daily  f(>r  from  ten  to  fifteen  minutes,  the  rule  in  all  cases 


^ 


Fig.  .56.     Eustachian  Electrode. 


v,'he\\  this  current  is  employed,  until  marked  improvement 
is  made,  and  then  on  alternate  days.  The  etiect  of  this 
plan  of  treatment  is  usually  to  leave  the  nasal  i)assiiges 
open,  at  least  on  one  side  if  there  is  a  deviated  sei)tuni. 
The  method  .slu)uld  also  be  employed,  in  the  author's  judg- 
ment, after  all  operative  procedures  in  the  nasal  cavities, 
as  after  the  removal  of  the  turbinates. 


WJ' 


Fio.  57.    Electrode  for  Treatiog  Turbinates  and  Meatus  of  Eustachian  Tube. 


In  postnasdl  uhf  rs  the  dircft  vaciniiii  tubr  (urrciit  with 
electrodes  vari<msly  shajK^l  t'(»r  ada])tation  to  surfaces  re- 
quiring; treatment,  are  remarkably  ctlicaiioiLs  in  r4'moving 
the  iiKluralion  and  healing  ulcerations.  The  electrodes 
shown  in  Figs.  ~t~  and  58,  are  often  of  aid  in  reachiug 
remote  places  in  the  nasal  cavity. 


232 


HIGH-POTENTIAL  CURRENTS 


Hay  fever,  hais  been  successfully  treated  by  Dr.  Tice  of 
Roanoke,  Va.,  by  an  electrode  designed  by  himself,  Fig. 
59.  In  the  treatment  of  these  cases  he  first  applies  a 
najsal  spray  of  an  oily  eomsistency  and  then  applies  the 
electrode  far  back  in  the  nares  for  ten  or  fifteen  minutes 
daily.     The  results  reported  aire  very  encouraging. 


Fig.  58.     Dr.  Tice's  Nasal  Electrode. 

Chilblains  following  frost  bite  are  very  promptly  re- 
lieved by  the  thorough  application  of  the  static  brush  dis- 
charge to  the  involved  parts  of  the  feet  until  the  infiltration 
and  consequent  soreness  is  entirely  removed.  The  author 
has  never  used  a  method  which  has  given  such  satisfaction 


Fig.  59.   Dr.  Arnold  Snow 's  Hemorrhoidal  Vacuum  Electrodes.     Three  Sizes. 


as  the  static  brush  discharge  in  these  cases. 

In  simple  ulcers  of  the  rectum,  the  application  of  vacuum 
tubes  is  always  efficacious  if  the  application  is  made 
directly  to  the  tissues  surrfounding  the  ulcerated  surfaces. 
With  the  induipatioai  removed,  these  ulcers  heal  promptly. 

Fissure  in  ano  is  always  successfully  treated  by  the 


THERArEUTICS  IN  INFLAMMATION        233 

employment  of  a  vatmiin  cloc'tnKle  which  will  vsli}::htly 
distend  the  anus  as  the  hemin'rhoidal  electnnle  shown  in 
Fij,'.  00,  hemorrhoidal  electrodes  designed  by  Dr.  Arnold 
8now,  employing  the  direct  vacuum  tube  curi"ent  for 
fifteen  minutes  daily.  The  lK>wels  should  1h'  kept  loiKse  for 
five  or  six  days  to  permit  healing  of  the  edgi^s.  The  prin- 
ciple here  as  in  other  processes  is,  that  the  induration  is 
removed  from  the  edges  of  the  fissure,  when  the  surfaces 
rapi<lly  heal.  No  better  method  can  be  devised  for  the 
treatment  of  these  distressing  cases.  If  an  electrode  is 
iis<hI  liU'ge  enough.  aft^-T  the  first  application  to  pass  in 
and  distend  the  anus,  it  is  also  capable  of  overcoming  the 
anal  spasm  thereby  greatly  facilitating  the  healing  process. 

1)1  hcmon'hoicls  the  treatment  by  the  vacuum  or  metal 
electrode  is  elfective  in  all  early  ciises  associated  with  the 
removiil  of  the  cause.  In  these  cases  the  induration  is  not 
of  an  organic  character,  and  the  infiltration  is  promptly 
relieved  and  tone  restored  to  the  hemorrhoidal  veins.  The 
electrode  shown  in  Fig.  59,  wais  designed  by  Dr.  Arnold 
Snow  for  the  treatment  of  these  cases.  The  shouhler  of 
the  electrode  should  be  pressed  firmly  against  the  external 
hemorrhoids  if  present.  These  electrodes  are  made  in 
three  sizes,  and  should  be  used  Tsith  a  view  to  distending 
the  anus  after  the  firs-t,  treatment,  in  order  to  overcome 
the  muscular  spasm  of  the  sphinctei*  ani  muscle. 

FoUoicing  operations  for  hemorrhoids  the  employment 
after  the  first  five  <lays  of  the  same  electrode  as  is  used  in 
the  treatnK'ut  of  hemon*hoids,  will  reni-<»ve  the  infiltration 
from  the  margins  of  the  ojK'ration  wound,  promptly  relieve 
the  sutTering  and  di.seomf<»rt  of  the  patient  with  the  first 
treatment^  facilitate  the  healing,  and  prevent  subsequent 
formation  of  sicar  tissue  and  conse<iuent  narrowing  of  the 


234  HIGH-POTENTIAL  CURRENTS 

rectal  canal.  No  more  sane  or  sensible  method  can  be 
employed  than  this  in  connection  with  the  surgery  of  the 
rectum.  It  is  cordially  recommended  to  the  surgeon  and 
his  patient. 

Glass  vacuum  electrodes  are  generally  used  in  the 
mucous  cavities  because  they  com])in'e  with  the  action  of 
the  current  in  addition  to  inducing  contraction;  a  local 
antiseptic  effect  which  is  important  in  the  mucous  cavities. 

Contusions  with  or  without  trauma  should  be  always 
treated  on  the  same  principle  as  sprains  and  other  non- 
infected  inflammatory  conditions.  The  brush  discharge  on 
or  about  a  trauma  or  the  wave  current  brush  discharge 
or  direct  vacunm  tube  current  over  a  bruise  will  remove 
every  evidence  of  soreness  in  two  or  three  applications. 
It  is  of  the  utmost  importance  to  apply  these  measures 
over  bruises  particularly  of  the  female  breast,  to  which 
are  attributed  so  often  the  cancer  which  appears  in  later 
years. 

Ecchymoses  disappear  with  remarkable  rapidity  under 
the  applications  of  the  static  brusih  discharge.  The  cellu- 
lar gymnastics  induced  in  the  tissues  increasing  absorp- 
tion and  elimination  of  the  cells  by  the  lymphatic  channels. 

Following  fractures  or  dislocations,  the  employment  of 
the  static  brush  discharge  over  the  swollen  or  painful  struc- 
tures relieves  all  of  the  pain  and  tenderness.  When  a 
fracture  is  put  up  in  thin  veneer  splints  of  wood,  it  is 
possible  to  make  the  application  through  the  dressing  re- 
lieving the  swelling  and  promoting  a  more  rapid  repair 
of  the  process.  Particularly  valuable  is  this  in  treating 
fractures  in  the  vicinity  of  the  joints  in  which  ankylosis 
is  apt  to  occur. 


THERAPEUTICS  IN  INFLAMMATION        235 

The  followiug  case  illustraU^s  the  efficiency  <»f  these 
mcKlaJities  in  the  treatment  of  severe  injuries. 

The  author  recalls  a  case  of  severe  injury  of  the  foot 
in  which  that  member  was  swollen  to  alH)ve  twice  the 
n«atural  size,  and  contused  at  two  pi>iuts,  with  ecchymosis 
exteniliiuj;  from  the  tot»s  back  to  within  an  inch  or  two 
of  the  hei'l,  a  iieavy  wejt^ht  havini^  falh'n  upon  it.  \Mth 
treatment,  this  man,  a  laborer,  was  able  to  resume  work 
within  a  week  from  the  time  c)f  the  injury  and  to  walk 
within  two  days  with  i)ut  slig-ht  discomfort.  The  first 
application  of  the  brush  discharge  to  this  foot,  following 
th<'  wave  current,  required  forty  minutes  to  .soften  the 
tissues,  and  at  lea.st  half  that  time  at  each  sul)s<'quent 
daily  administration;  the  relief  that  was  aflforded  how- 
ever, was  ample  reward  for  the  time  expended.  Such 
results  can  be  obtained,  we  believe,  in  no  other  manner, 
and  probably  the  static  brush  discharge  is  better  adapted 
for  the  treatment  of  superficial  contusions  than  any  other 
niixlality.  In  lieu,  however,  of  the  static  machine,  the 
reBonat<>r  sparks  from  a  coil  are  of  great  value. 


I 


CHAPTER  VII. 

TEEATMENT   OF  INFLAMMATION   CAUSED  BY    INFECTION 

Inflainmatioii  whicJi  is  caused  by  infection  can  only  be  treated 
successfully  by  the  termination  of  tbe  infectious  process,  wbicli 
is,  therefore,  the  indication  of  first  importance  to  be  observed. 

Left  to  natural  processes,  infection  may  be  limited  by  the 
walling  in  of  the  germs  until  they  perish  finally  by  attenua- 
tion and  overgrowth  in  the  limited  space  in  which  they  exist. 
The  pressure  due  to  the  limited  cavity  in  which  the  germs  de- 
velop, causes  pain  during  a  suppurative  process,  and  tennin- 
ates  the  process  finally  with  evacuation  of  the  germs  in  the 
direction  of  least  resistance.  This  is  the  usual  course  of  a 
pyogenic  infection. 

In  other  cases  in  which  the  inflammatory  process  is  less 
active,  as  in  tubercular  infections,  the  inflammation  may  ex- 
tend gradually  involving  the  surrounding  tissues,  thereby 
broadening  and  enlarging  the  scope  of  infection.  While  the 
latter  action  is  insidious,  the  destructive  action  by  the  growth 
and  extension  of  the  germs  in  the  lower  grades  of  inflamma- 
tion, lead  to  more  extensive  disintegration  of  the  structures 
of  the  region  involved. 

The  germs  most  commonly  the  sources  of  localized  inflam- 
mation are  the  streptococci,  staphylococci,  pneumococci,  tu- 
bercle bacilli,  gonococci,  anthrax,  the  germs  of  typhoid  fever 
and  tetanus,  and  in  the  early  stage  of  infection  the  spirilum 
of  syphilis.  Most  other  germs  act  upon  the  organism  with 
the  production  of  a  general  infection  from  the  outset,  with 

236 


TRE.VTMENT  OF  INFI^VMMATION  237 

some  specific  or  localized  mauifestations,  as  do  the  exantho- 
mata. 

The  conditions  which  favor  the  institution  of  an  infectious 
process  upon  the  organism,  particularly  the  tubercular,  stre|> 
tococcic,  staphylococcic  and  pneumococcic  infections,  is  a  low- 
ered resistance  or  phagocytosis,  which  favors  the  implanta- 
tion of  the  germs  in  a  colony  where  they  will  not  be  promptly 
destroyed  by  the  natural  scavengers.  Likewise,  the  restora- 
tion of  the  individual  once  infected  is  more  speedy  and  prompt 
when  the  index  of  resistance  is  relatively  high.  Wright  in 
his  researches  has  shown  that  under  certain  physical  condi- 
tions, phagocytic  activity  and  capacity  to  take  up  germs  is 
greater  while  in  other  individuals  they  will  take  up  many 
less  when  exposed  to  similar  infection. 

Influences  which  undermine  the  general  health  and  nutri- 
tion of  the  individual  lower  the  index  of  phagocytosis,  under 
which  conditions  an  invasion  will  be  more  likely  to  take  place 
and  the  process  will  be  more  active  and  less  limited  in  extent. 

It  is  under  conditions  of  lowered  resistance  that  individu- 
als are  much  more  susceptible  to  streptococcic,  staphylococcic 
and  tubercular  infection.  In  these  cases  of  lowered  resist- 
ance response  to  physical  treatment  is  also  relatively  slow. 

The  indication  for  the  treatment  of  every  case  of  infection, 
therefore,  points  first  to  the  increase  of  the  individual's  re- 
sistance, or  capacity  to  wall  off  or  bar  the  inroads  of  infec- 
tion, which  demand  the  improvement  of  general  and  local 
metabolism  by  systematic  regulation  of  nutrition  which  will 
depend  upon  the  observance  of  such  a  hygienic,  dietary  and 
sanitary  regime  as  will  tend  to  restore  and  preserve  the  health 
of  the  individual.  For  example  in  tuberculosis  the  cause  which 
led  to  it  must  be  first  discovered  and  corrected,  as  well  as 
keeping  the  patient  out  of  doors  in  the  fresh  air.     The  regu- 


238  HIGH-POTENTIAL  CUEKENTS 

lation  of  diet  and  exercise  and  the  correction  of  metabolism 
as  accomplished  by  efficient  means  including  radiant  light 
and  the  high  potential  currents  are  all  indicated  in  persons 
whose  resistance  is  lowered.  When  a  fairly  active  metabolism 
cannot  be  maintained  by  exercise,  such  measures  as  radiant 
light  and  heat,  the  electrical  currents,  massage,  ot  other  means 
which  arouse  the  functions  must  be  employed  to  improve 
both  the  general  and  local  activities. 

The  means  which  are  employed  in  the  treatment  of  local 
infection,  are  (1)  those  which  act  directly  upon  the  germs 
to  destroy  them,  which  is  often  possible  when  they  are  ac- 
cessible as  when  they  are  at  the  surface,  by  the  employment 
of  radiant  light  and  the  high  frequency  currents;  (2)  agents 
which  while  inhibiting  or  lessening  the  activity  of  the 
germs,  co-incidently  increase  by  the  induction  of  hyperemia 
the  activity  and  presence  of  phagocytes  in  the  region  of  in- 
fection, and  may  coincidently  arrest  the  activity  of  the  germs : 
and  (3)  the  use  of  means  which  arrest  the  proliferation  of 
the  germ  processes  as  do  radium  and  the  Roentgen  ray. 

The  scope  of  this  work  is  confined  to  the  employment  of 
the  high  potential  currents,  but  it  is  important  that  refer- 
ence be  made  from  time  to  time  to  other  measures  which  as- 
sist in  arresting  infectious  conditions  by  the  local  destruction 
of  germs. 

The  high  potential  currents,  particularly  those  of  high  fre- 
quency, are  remarkably  efficient  in  inducing  hyperemia  in 
the  tissues.  Probably  no  condition  plays  a  greater  role  both 
from  the  point  of  view  of  increasing  local  tissue  resistance 
and  local  metabolism,  than  hyperemia  with  the  presence  coin- 
cidently of  a  greater  number  of  phagocytes  in  the  tissues; 
and  for  the  induction  of  hyperemia  no  agen1?  is  so  effective 
as  these  currents. 


TREATMENT  OF  INFLAMMATION  239 

The  einployiiient  of  the  means  referred  to,  for  the  treat- 
ment of  local  infection  were  considered  at  length  in  a  pre- 
vious chapter. 

The  application  of  the  vacuum  tubes  excited  with  the 
proper  energy  to  the  surface,  when  the  lesion  is  superticial, 
induces  sufficient  hyperemia  to  effectively  abort  or  arrest  in- 
fection by  the  hyperemia  induced,  and  when  very  superficial 
by  the  direct  action,  actinic  and  antiseptic,  upon  the  germs 
at  the  surface  and  a  little  distance  within  the  tissues. 

The  vacuum  tube  discharges  are  particularly  efiicient  in 
the  treatment  of  infection  within  the  mucous  cavities,  and 
to  small  boils  and  carbuncles  superficially  located.  When  the 
direct  d'Arsonval  current  is  passed  directly  through  the  tis- 
sues and  the  vacuum  electrode  is  applied  from  one  terminal 
over  the  infected  region,  hyi>eremia  is  induced  to  a  greater 
depth,  and  with  greater  certainty  than  when  applied  from  an 
Oudin  or  other  one  pole  current. 

The  static  direct  vacuum  tube  current,  employing  a  vacuum 
tube  connected  directly  from  a  static  machine  and  with  the 
same  arrangement  (Fig.  1),  as  the  static  wave  current,  may 
also  be  employed  effectively  in  the  treatment  of  early  infec- 
tion ;  i.  e.  during  the  first  stage  of  an  infection ;  when  the  ir- 
ritation indicates  the  beginning  of  an  infectious  process,  but 
before  a  piis  cavity  is  established.  By  this  means  it  is  pos- 
sible to  abort  a  felon  or  furuncle,  or  suppurative  tonsilitis  in 
its  first  stage,  and  arrest  the  process.  The  application  is 
made  with  the  employment  of  as  long  a  spark-gaj)  as  can 
be  borne  by  the  patient  without  producing  too  great  suffering, 
and  is  continued  until  the  tissues  are  thoroughly  softened 
which  will  require  from  ten  to  twenty  minutes,  when  the 
few  germs  are  let  loose  in  the  tissues,  to  be  destroyed  by  the 
phagooytec.      The   application    may    have   to   be    repeated    on 


240  HIGH-POTENTIAL  CURRENTS 

one  or  two  days  following  the  first  treatment.  There  is  no 
danger  when  employing  this  method  in  the  first  stage  of  infec- 
tion; but  after  approximately  thirty-six  hours,  great  care  must 
be  exercised,  lest  the  infectious  process  may  have  developed 
80  many  germs  that  they  will  be  scattered  and  the  infection  ex- 
tended. 

The  direct  d'Arsonval  method  of  treating  infection  presup- 
poses the  induction  of  an  intense  hyperemia  throughout  and 
surrounding  the  region  infected.  The  idea  of  considering 
the  use  of  any  method  without  the  recognition  of  the  factors 
which  enter  into  the  result,  is  too  often  the  disposition  of 
pioneers.  That  habit,  however,  always  leads  to  confusion,  and 
the  adoption  of  empirical  methods,  which  for  the  enlighten- 
ment of  the  student,  is  unsatisfactory.  The  principles  of 
action  of  every  modality  upon  the  tissues  should  be  fully 
recognized  by  all  who  expect  to  use  it  intelligently. 

Hyperemia  in  the  tissues  as  previously  shown,  effects  three 
important  results;  (1)  the  increased  flux  of  blood  through 
the  tissues  increases  metabolism,  both  anabolic  and  catabolic; 
(2)  it  supplies  to  the  tissues  the  needed  nutrition  for  repair- 
and  (3)  it  carries  into  the  tissue  with  the  increased  blood 
flux,  a  proportional  increase  of  the  phagocytes  which  last  ex 
ercises  the  chief  influence  of  hyperemia  upon  infection.  An- 
other element  to  be  recognized  in  connection  with  this  in- 
creased flux  through  the  tissues,  is  a  tendency  when  the  ca- 
pillaries and  arterioles  dilate,  to  force  the  circulation  through 
the  tissues;  thereby  when  employed  early  resolving  or  pre- 
venting the  establishment  of  local  stasis.  When  once  estab- 
lished, however,  with  the  presence  of  marked  swelling  and 
induration  it  is  impossible  to  resolve  stasis  by  these  measures. 
When  a  pus  cavity  is  once  established,  hyperemia  plays  no 
important  role  until  the  pus  is  evacuated,  after  which  the  in- 


TREATMENT  OF   INFLAMMATION  241 

(Juction  of  bvpert'inia  hy  the  employment  of  radiant  light  and 
heat  and  high  fr^iuency  currents,  favors  rapid  restitution  of 
the  partt.  This  principle  applies  more  particularly  to  the 
streptococcic  and  staphylococcic  infections;  whereas  in  the  low 
grade  tubercular  infections,  or  other  infections  in  which  in- 
duration is  not  established  to  the  same  extent,  the  tissue 
being  much  more  relaxed  and  flaccid  permit  the  circulation 
of  blood  throughout  under  the  stimulus  of  any  agent  that 
produces  heat  and  with  it  active  hyperemia  in  the  tissues. 
The  vaso-motor  reflexes  provide  that  wherever  the  tissues  are 
heated  or  cooletl,  there  will  be  an  increased  flow  to  the  piirt 
with  dilatation  of  the  arterioles  in  the  region  so  infected. 

The  bipolar  direct  d'Arsonval  method  is  employed  for  ther- 
mic effects  with  a  current  of  the  requisite  amperage  passed 
directly  through  the  part  involved.  The  tissues  are  thus 
heated  to  an  extent  relative  to  the  amperage  of  the  current 
employed  and  the  size  of  the  two  opposite  electrodes.  By 
this  method  it  is  possible  to  affect  deep  seated  infection,  as  in 
the  pelvis  or  liver,  and  is  always  indicated  in  such  processes. 
It  must  be  borne  in  mind,  however,  that  when  an  infection 
is  immediately  beneath  the  surface,  it  is  better  to  employ  the 
vacuum  tube  over  the  site  of  infection  as  previously  des- 
cribed, because  the  thermic  effect  of  the  direct  d'Ar?cnval 
current  is,  as  a  rule,  more  marked  at  a  point  about  midway  be- 
tween the  two  electrodes;  but  when  the  vacinnu  tube  is  em- 
ployed at  the  surface,  the  hyperemia  will  be  more  marked 
there  also. 

The  ireafmenf  of  otitis  media,  mnMoiditis  an^  supi>urnfire 
processes  in  the  frorUal  sinuses  is  probably  most  effective 
when  treated  by  proloiiired  ap{)lieations  of  radiant  light  and 
heat  from  an  intense  radiating  source  as  from  the  focussed 
light  of  a   fifty  candle  power  incandescent  lamp,  held  close 


242  HIGH-POTENTIAL  CUREENTS 

enough  to  require  moving  about  to  prevent  discomfort  to  the 
patient.  In  these  cases  the  application  of  the  high  frequency 
current  with  vacuum  tubes  are  probably  not  so  effective  as 
light,  but  may  be  always  considered  as  congeners  in  the  treat- 
ment of  these  cases.  Radiant  energy  undoubtedly  penetrates 
more  deeply  into  bony  structures  than  the  high  frequency 
currents,  and  is  more  effective  as  a  means  of  inducing  hy- 
peremia in  these  cases. 

Pelvic  cellulitis,  salpingitis,  and  gonorrheal  infection,  are 
best  treated  by  the  high  frequency  current  employing  the  di- 
rect d'Arsonval  method  with  one  electrode  placed  immediately 
above  the  pubis,  and  the  current  passed  directly  through  the 
pelvic  structures  for  twelve  to  fifteen  minutes,  when  metal 
is  used  in  the  rectum  instead  of  glass  the  current  may  be 
applied  for  a  longer  time  because  it  does  not  irritate  the  mu- 
cous membrane  as  the  vacuum  tube  discharges  do.  The  cur- 
rent when  employing  the  vacuum  tubes  should  be  used  with 
a  volume  that  can  be  tolerated  at  the  rectal  side.  The  dos- 
age in  the  employment  of  the  direct  d'Arsonval  current  in 
most  cases,  must  be  regulated  to  the  thermic  toleration  of 
the  patient,  which  will  as  a  rule  not  be  so  great  when  a 
vacuum  electrode  is  used  as  previously  explained. 

In  abscess  of  the  liver,  or  appendicitis,  chronic  or  acute, 
the  same  principle  of  application  is  employed  as  in  the  treat- 
ment of  pelvic  infection,  though  it  is  often  better  in  these 
cases  to  employ  two  metal  electrodes  at  opposite  sites  in  such 
a  manner  that  will  be  certain  to  convey  current  through  and 
around  the  infected  parts. 

In  adenitis,  either  tubercular  or  streptococcic,  the  high  fre- 
quency current  by  the  bipolar  direct  d'Arsonval  method  should 
be  employed  following  a  series  of  applications  of  the  Roentgen 
ray — applying  the  ray  until  a  dermatitis  has  been  reached, 


TREATMENT  OF  INFLAMMATION  243 

and  then  persisting  with  the  hyperemia  employing  congeners 
— the  high  frequency  current  and  radiant  light  and  heat — 
to  the  parts  involved.  By  this  method  it  is  possible  to  effectu- 
ally arrest  or  abort  these  cases  with  few  exceptions;  the  ex- 
ceptions as  a  rule  being  due  to  want  of  thoroughness  in  tech- 
nique. 

In  pulmonary  tuberculosis,  the  indications,  as  previously 
suggested,  are  to  improve  in  every  way  possible  the  metabol- 
ism and  nutrition  of  the  patient,  and  when  there  is  an  asso- 
ciated high  arterial  tension,  to  employ  the  auto-condensation 
method  both  for  the  effects  upon  blood  pressure  and  general 
metabolism.  Following  a  series  of  irradiations  with  the  x-ray 
over  the  lungs,  the  employment  of  the  direct  d'Arsonval  cur- 
rent, applying  on  alternate  days  a  large  metal  electrode  over 
the  chest  in  front,  and  a  vacuum  electrode  over  the  back, 
moving  it  about  over  the  surface  regularly,  changing  the 
sites  of  application  on  alternate  days,  so  that  the  metal  plate 
and  vacumn  tube  are  employed  alternately  front  and  back 
on  the  chest  wall.  The  hyperemia,  deep  and  superficial,  in- 
duced by  this  method  following  the  x-ray  favors  the  destruc- 
tion of  the  local  infection ;  and  with  these  applications  the 
patient's  nutrition  and  appetite  steadily  improve,  with  a  cor- 
responding improvement  in  general  phagocytosis,  and  the  pro- 
cess is  arrested. 

There  is  no  doubt  that  in  these  cases  the  application  of 
radiant  light  and  heat  and  the  high  frequency  currents  have 
a  decided  action  upon  the  blood,  circulating  where  hyperemia 
of  the  skin  is  present — increasing  the  percentage  of  hemoglo- 
bin, and  by  the  stimulated  activity  of  l}Tuphatics  and  sweat 
glands  ridding  the  blood  of  deleterious  toxins. 

In  cold  abscesses  there  is  probably  little  to  be  expected  from 
these  applications,  though  it  is  possible  that  in  some  instances 


244  HIGH-POTENTIAL  CURRENTS 

with  the  increase  of  general  resistance  by  the  employment  of 
active  measures,  which  improve  general  metabolism  and  nutri- 
tion, that  they  may  to  a  degree  effect  the  absorption  of  the 
accumulated  pus. 

In  tubercular  and  other  infectious  types  of  arthritis,  in 
which  the  germs  are  present  in  the  joint,  the  most  effective 
method  of  treatment  is  the  application  of  the  bipolar  direct 
d'Arsonval  current  either  by  the  application  of  two  metal 
electrodes  or  one  metal  and  one  surface  vacuum  electrode  pass- 
ing the  current  directly  through  the  affected  joint,  with  a  cur- 
rent capable  of  producing  a  temperature  sufficient  to  cause  a 
sense  of  warmth  through  the  tissues.  Here  as  in  other  infec- 
tious diseases  the  induction  of  hyperemia  and  phagocytosis 
in  the  tissues  is  remarkably  effective  in  the  early  cases  in 
bringing  about  the  restoration  of  the  joint. 

These  administrations  however,  should  be  preceded  by  a  se- 
ries of  x-ray  irradiations;  when  radiant  light  and  heat  may 
also  be  employed  in  conjunction  with  the  high  frequency  cur- 
rent. The  x-ray  should  be  employed  until  there  have  been 
enough  regulated  short  exposures  given  on  alternate  days  to 
produce  a  commencing  dermatitis,  when  the  agents  which  in- 
duce hyperemia  should  be  employed  daily,  and  with  energy 
until  the  joint  is  well  and  every  sign  of  infection  is  removed. 

In  tubercular  adenitis  practically  the  same  routine  is  em- 
ployed as  in  other  tubercular  inflammations,  employing  the 
x-ray  on  alternate  days  with  ten  minute  exposures  with  the 
usual  intensity  of  x-rays  until  the  glands  disappear,  or  a  der- 
matitis occurs ;  when,  if  the  bipolar  d'Arsonval  current  is  em- 
ployed with  a  surface  electrode  of  metal  back  of  the  gland, 
and  a  vacuum  electrode  over  the  gland,  for  the  induction  of 
active  hyperemia  in  many  cases  a  cure  is  promptly  effected. 
In  other  cases  it  may  be  necessary  to  resume  the  x-ray  and 


TKEATMENT  OF  INFLAMMATION  245 

follow  out  the  same  routiue  with  the  bipolar  liigh  frcqiicnej  cur- 
rent, after  the  dermatitis  occurs.  The  improvement  in  gen- 
eral health  of  these  patients  and  gain  in  weight  is  remark- 
able. Xo  measure  is  more  effective  in  any  class  of  conditions 
than  the  combined  use  of  the  x-ray  and  high  frequency  cur- 
rent in  tubercular  adenitis. 

While  the  x-ray  is  effective  when  used  singly  in  these  cases, 
if  the  high  frequency  current  is  employed,  and  is  successful 
after  the  first  irradiation,  the  functions  of  the  gland  are  much 
less  impaired  than  if  the  x-ray  is  persisted  in  alone  until 
the  case  is  cured. 

Local  tuhercular  affections  wherever  present,  should  be 
treated  on  the  same  general  principles  as  in  the  treatment 
of  tubercular  arthritis  and  tubercular  adenitis. 

In  gonorrheal  arthritis,  in  which  the  germs  are  propagat- 
ing at  some  foci  of  active  infection,  of  which  the  joint  is 
but  a  toxic  manifestation,  the  indication  is  always  to  relieve 
the  local  infection.  In  chronic  cases  this  is  as  a  rule  in  the 
vesicles  prostate  or  vern  montanum.  If  so  the  application 
of  the  bipolar  direct  d'Arsonval  current  with  a  glass  vacuum 
electrode  (fig.42)  placed  against  these  structures,  and  a 
metal  electrode  above  the  pubis  for  ten  or  fifteen  minutes, 
followed  by  fifteen  to  twenty  minutes  of  the  static  wave  cur- 
rent against  the  prostate  and  vesicles  in  the  rectum  is  uni- 
formly effective. 

The  high  frequency  current  should  be  applied  in  a  man- 
ner which  will  produce  as  much  heat  as  possible  without  caus- 
ing an  uncomfortable  sense  of  heat  in  the  tissues.  Under 
these  conditions  there  will  be  a  sense  of  general  warmth  and 
in  most  cases  the  patient  will  perspire. 

In  some  cases  it  may  be  necessary  to  make  the  applica- 
tion of    the  high  frequency  currents  to  the  veru   montanum 


I 


246  HIGH-POTENTIAL  CURRENTS 

through  the  urethra  which  may  likewise  be  the  seat  of  in- 
fection, and  sources  of  the  toxemia.  In  most  cases  however 
the  condition  will  be  relieved  bj  the  rectal  application. 

Cases  that  have  been  crippled  for  weeks  and  months  are 
promptly  relieved  and  cured  by  the  combined  method,  which 
consists  in  applying  the  vacuum  electrode  by  the  bipolar  meth- 
od with  the  direct  d'Arsonval  current  placing  a  small  metal 
electrode  over  the  pubis  and  a  glass  vacuum  electrode  in  the 
rectimi,  followed  by  a  twenty-minute  application  of  the  static 
wave  current  with  the  metal  rectal  electrode  placed  well  up 
in  contact  with  the  prostate  and  vesicles.  The  direct  vac- 
uum tube  current  is  also  efficacious  when  employed  in  con- 
junction with  the  static  wave  current  in  these  cases. 

Reports  have  also  been  made  of  numerous  cases  in  which 
the  wave  current  alone  has  cured  these  cases.  On  general 
principles  however,  the  hyperemic  and  antiseptic  effects  of 
the  vacuum  tube  currents  add  another  promising  element  in 
the  treatment  of  these  cases. 

In  acute  epididymitis  of  gonorrheal  origin  the  following 
method  is  remarkably  effective.  Apply  the  vacuum  tube  di- 
rectly over  the  site  of  the  lesion,  and  have  the  patient  hold  it 
in  contact  employing  the  direct  vacuum  tube  current  with 
an  ordinary  surface  electrode  or  what  is  better  one  having  a 
concave  face  (fig.  53).  These  cases  are  usually  cured  in  this 
manner  in  two  or  three  applications:  the  relief  afforded  by 
the  first  application  is  certainly  remarkable.  The  electrode 
should  be  applied  to  the  tender  surfaces  over  the  induration, 
moving  it  about  until  the  part  is  softened  and  not  very  sensi- 
tive to  manipulation  at  the  first  administration.  The  chair 
in  which  the  patient  is  seated  should  be  placed  at  such  an 
angle  with  the  static  machine,  that  the  connecting  cord  or 
wire   will    not   come    in   contact    with   the   patient's   body    or 


TKEATMENT  OF   INFLAMMATION  '2i7 

arms  during  the  admiuistrutiou.  With  oue  hand  ou  tke  vac- 
uum tube  holder  the  electrode  should  be  held  in  position  with 
the  other  hand  with  a  towel  between  the  electrode  and  the  hand. 
Tke  spark  gap  should  be  lengthened  until  it  causes  as  much 
pain  as  can  be  tolerated  by  the  patient  without  causing  too 
great  discomfort  and  the  administration  should  be  continued 
until  little  or  no  pain  is  caused  at  the  site  of  the  lesion  when 
a  long  spark-gap  is  discharging.  There  is  no  little  manoeuvre 
in  medicine  that  will  more  favorably  impress  the  genito-urin- 
ary  surgeon  than  the  treatment  of  an  epididymitis  by  this 
method. 

Acute  and  chronic  appendicitis  may  often  be  treated  and 
relieved  by  the  employment  of  radiant  ligh.t  and  heat  and  the 
direct  d'Arsonval  current,  employing  the  same  principles  and 
methods  of  treatment  suggested  in  the  preceding  paragraphs. 
It  is  well  in  the  chronic  ca^es  to  precede  the  treatment  for 
tke  induction  of  hyperemia  by  the  x-ray  following  very  much 
the  same  routine  as  in  the  treatment  of  tubercular  arthritis. 
The  results  are  quite  remarkable  and  in  the  majority  of  cases 
of  chronic  appendicitis  it  is  possible  to  restore  the  parts  to 
normal  or  a  fairly  healthy  condition.  In  a  great  many  cases 
of  acute  appendicitis,  five  or  six  daily  applications  of  radiant 
light  and  heat  of  twenty  to  thirty  minutes  each,  will  effec- 
tively arrest  the  process  as  will  be  evidenced  by  the  fall  of 
temperature,  relief  of  muscular  tension,  spasm,  and  pain. 
These  results  have  been  obtained  by  the  writer  so  frequently 
that  he  feels  justified  in  recommending  their  employment. 

In  salpinfjiiis,  pelvic  cellulitis,  and  pj/o-saJpitur,  the  effects 
of  the  direct  d'Arsonval  current  and  radiant  light  and  heat 
are  often  most  remarkable  and  in  the  early  stages  will  ar- 
rest the  active  processes,  and  in  chronic  cases  when  employed 
in  conjunction  with  the  Roentgen  ray  a?  in  other  infectious 


248  HIGH-POTENTIAL  CURRENTS 

conditions,   will   often   produce    results   which   will    eliminate 
the  necessity  of  operative  procedures. 

In  infectious  conditions  often  present  in  the  mesentery  and 
colon,  the  effects  of  the  direct  d'Arsonval  current  and  radiant 
light  and  heat  are  likewise  remarkable,  altering  the  infec- 
tious process  and  co-incidently  quickening  the  processes  of  met- 
abolism and  absorption.  There  are  probably  no  means  which 
give  greater  assistance  to  the  internist  than  the  treatment  of 
chest,  abdominal  and  pelvic  conditions  by  the  joint  adminis- 
tration of  radiant  light  and  heat  and  the  high  frequency 
currents. 


CHAPTER  VIII 

THE  METHOD  OF  KFFLEUVATION  OTHERWISE  DESIGNATED 
FULGUEATION 

The  application  of  a  high  frequency  discharge  from  a  metal 
point  with  a  current  of  sutHcient  energy  to  destroy  living  tis- 
sue, was  first  described  and  instituted  by  Dr.  J.  A.  Riviere 
of  Paris,  France.  He  employed  the  method  for  the  destruc- 
tion of  cpitheliomata,  warts,  moles  and  condolomata.  His 
student,  Kaeting-Hart,  employing  the  same  method  in  con- 
nection with  the  operative  treatment  of  cancer  of  the  breast, 
with  a  view  to  prevent  secondary  recurrence  by  following  the 
knife  with  the  application  of  the  same  method  designated  the 
process  as  "fulguration,"  giving  the  original  investigator  uo 
credit  for  the  originality  of  the  method.  His  associations 
as  a  surgeon  led  to  the  adoption  of  the  latter  namo  which  is 
the  designation  of  the  eifect  and  not  of  the  method ;  the  method 
being  a  hot  effleuve  discharge  and  the  effect  one  which  simu- 
lates burning. 

The  process  of  effleuvation  may  be  applied  either  for  a  cAut- 
erant  effect  or  as  a  desiccating  agent  as  described  by  Clark;* 
the  discharges  in  one  case  destroying  the  tissue  by  actual 
chemical  decomposition  of  heat,  and  the  other  process  by  ap- 
plying the  current  with  sufficient  strength  to  produce  a  drying 
out  of    the   tissue  with   the   induction   of    coagulation-necro- 


•Oscillatorj-  Desiccation  in  theTrcatmcnt  of  Acce<sible  Mali):^.int  Growthn 
and  Minor  Surj^ical  Conditions.  A  New  Process.  Dr.  William  L.  Clark, 
Philadelphia,  Pa.,  Journal  of  Advanced  Therapeutics,  April,  1911. 

249 


250 


HIGH-POTENTIAL  CURRENTS 


sis.     Wlien  thermic  application  is  made  in  the  tissues,  above 
73°  C.  coagulation-necrosis  is  induced. 

Another  method  which  to  a  degree  stimulates  effleuvation  in 
its  effects,  though  not  in  the  methods  of  application,  is  the 
passage  of  the  direct  d'Arsonval  current  through  the  tissues 
employing  a  large  indifferent  electrode  of  metal  from  one  ter- 
minal to  the  surface  of  the  body  and  a  very  small  operating 
electrode  from  the  other  d'Arsonval  terminal.  By  this  method 
employing  operating  metal  electrodes  of  different  sizes  vary- 
ing from  that  of  a  needle  to  an  electrode  having  a  surface  of 


e^mn^^i^^^ 


Fig.   61.     Dr.   Cannon's  EfHeuvation  Electrode. 


one  or  more  millimeters  in  diameter,  it  is  possible  to  locally 
destroy  tissue  by  the  induction  of  coagulation-necrosis. 

In  the  application  of  these  different  methods,  the  effect  is 
practically  the  same,  the  tissues  being  destroyed;  but  where 
the  growth  is  very  superficial,  the  method  by  efileuvation  em- 
ploying electrodes  designed  to  get  the  desired  degree  and  ex- 
tent of  destruction  by  the  application  of  the  long  curved 
electrode  to  the  tonsils,  renders  the  process  a  very  easy  one 
to  employ.  Cuts  are  shown  here  of  different  designs  of  in- 
struments for  making  applications  by  this  method. 

The  Technique  will  depend  somewhat  upon  the  apparatus 
to  be  employed.     In  connection  with  the  small  portable  high 


THE  METHOD  OF  EFFLEUVATION  251 

frequcnev  a{)paratiis,  or  the  resonator  of  a  static  machine  or 
the  Kiihnikorff  coil  the  operator  should  test  the  strength  of 
the  current  upon  his  hand  before  beginning  the  application. 
The  possible  spark  length  should  not  exceed  one-sixteenth  to 
one-eighth  of  an  inch,  and  the  current  strength  or  amperage 
should  be  regulated  to  the  demands  or  intent  of  the  oj^erator 
necessary    to    meet    the    indications.      For    small    superficial 


Fiu.  62.     Waj.piL-r  Fulgurating  Electrode. 

growths,  it  is  not  necessary  that  the  current  should  be  of  great 
energy. 

The  area  to  be  treated  should  be  well  cocainized  either  by 
the  introduction  of  the  cocaine  by  the  hypodermic,  or  the 
ionic  method,  or  by  direct  application  to  the  mucous  sur- 
faces of  a  10%  solution. 

The  dosage  or  extent  of  the  application  to  a  particidar  con- 
dition is  largely  a  matter  of  personal  experience.  Every  op- 
erator should  acquire  his  technique  by  beginning  with  the 
treatment  of  superficial  skin  conditions. 


GLOSSARY 


.l//«.T»ia<i;i<;  Current.  One  which  tlowd  alternately  in  opposite  direc- 
tions usually  so  quickly  that  it  is  assumed  to  have  no  polarity.  The 
speed  of  alternations  is  expressed  in  frequencies. 

Am-metcr  (or  Ampere-meter) .  An  instrument,  calibrated  in  amperes 
or  arbitrary  divisions,  to  indicate  the  strength,  density  or  quantity  of 
current  passing  in  a  circuit. 

Amperage.     Strength  of  the  electrical  current  expressed  in  amperes. 

Ampere.  The  unit  of  density,  or  quantity,  or  strength  of  an  electrical 
current. 

.inaphoresis.  The  transmission  by  ionization  of  electro-positive  bodies 
into   the  tissues,  applied   from  tlie   positive  pole. 

Anion.  A  term  applied  by  Faraday  to  that  element  of  an  electrolyte 
which  in  electrochemical  decompositions  appears  at  the  positive  pole,  or 
anode,  as   oxygen   or   chlorine. 

Auto-condensation.  A  nietho<l  of  administering  the  d'Arsonval  current 
to  the  patient  upon  a  couch  having  an  insulated  cushion  underneath  the 
entire  length  of  which  is  a  metal  condenser  plate,  connected  by  a  metallic 
conductor  to  one  end  of  the  d'Arsonval  coil,  the  patient  being  connected 
to  the  other  end. 

Auto-mnduction.  A  method  of  administering  the  d'Arsonval  current 
with  the  patient  standing  or  sitting  within  a  large  solenoid  which  is 
connected  at  its  ends  to  the  two  terminals  of  a  d'Arsonval  solenoid;  the 
magnetic  lines  of  force  passing  through  the  body  of  the  patient,  who 
becomes  a  conductor  of  the  electric  currents  induced  thereby. 

Brush-discharge.  In  electrotherapeutics,  the  discharge,  disrupto-con- 
vective  in  character,  peculiar  to  the  passage  of  an  electrical  current 
through  resisting  substance  as  a  glycerine  tube  or  damp  wooden  electrode, 
which  produces  a  discharge  which  causes  a  sensation  as  of  hot  sand 
when  it  comes  against  the  skin  of  the  patient.  Tliis  term  is  also  applied 
in  electro  physics  to  similar  discharges  in  air  or  gases,  from  any  high 
potential  source. 

Capacity.  The  property  by  which  a  given  body  will  take  and  hold 
an  electrical  charge. 

Cataphoresis.  The  transmission  by  ionization  of  electro-negative  bodies 
into  the  tissues. 

Cathode.  The  negative  or  antipode  of  the  anode  element  in  an  electric 
couple. 

253 


254  GLOSSARY 

Cathode  Stream.  The  electrified  particles  passing  in  the  attenuated 
medium  of  a  vacuum  tube  from  the  cathode  to  the  anti-cathode;  and 
marking  the  direction  of  the  electrical  current  flow.  The  manifestation 
of  the  cathode  stream  has  demonstrated  the  error  of  the  long-recognized 
view,  that  the  electrical  current  passes  from  positive  to  negative,  it  being 
now  understood  that  the  current  passes  with  the  cathode  stream  in  the 
opposite  direction. 

Cation.  The  name  given  by  Faraday  to  the  element  or  elements  of  an 
electrolyte  which  in  electrochemical  decompositions  appear  at  the  negative 
pole  or  cathode,   as  hydrogen. 

Circuit-breaker.  An  electro-magnetic  device  actuated  by  excess  of  cur- 
rent:  in  some  cases  used   instead  of  a  fuse;   a  SAvitch. 

Condenser.  Any  apparatus  by  which  electricity  can  be  accumulated, 
usually  consisting  of  two  conducting  surfaces,  separated  by  a  non-con- 
ductor; as  the  Leyden  jar,  or  metal  plates  separated  by  glass  or  mica 
insulation. 

Conductive  Discharges.  Discharges  of  an  electrical  current  through  a 
metallic  conductor  to  the  patient. 

Conductivity.  The  capacity  of  a  body  to  conduct  a  current.  The  best 
conductor  is  that  which  ofi'ers  the  least  resistance. 

Coiivective  Dischurges.  Discharges  from  a  high  potential  source  which 
pass  in  the  form  of  visible  or  invisible  streams  of  electrical  energy  through 
the  air  to  the  patient;  as  the  static  spray  and  breeze. 

d'Arsonval  Direct.  A  method  by  which  the  current  between  the  opposite 
terminals  of  the  d'Arsonval  solenoid  are  passed  directly  through  the 
patient   between  two   electrodes. 

d'Arsonvalizatioii.  The  administration  of  electricity  by  the  method  of 
Prof.  d'Arsonval,  employing  the  d'Arsonval  current  with  either  the  auto- 
conduction,   auto-condensation  or  the  direct  bi-polar  method. 

Detonating  Chamber.  A  muffler  surrounding  the  discharging  balls  of 
a  static  machine  or  resonator  for  deadening  the  sound  of  a  spark  dis- 
charge. 

Dielectric.  An  insulating  substance  through  or  across  which  electric 
force  is  acting  by  induction  without  conduction — as  the  waJls  of  a  Leyden 
jar,  the  insulating  cushion  of  an  auto-condensation  couch,  or  an  air  space. 

Direct  Current.  A  current  flowing  in  one  direction.  It  may  be  con- 
stant pulsatory. 

Direct  Vacuum  Tube  Current.  A  current  administered  from  one  pole 
of  a  static  machine,  the  other  pole  of  which  is  grounded,  and  regulated 
by  the  discharging  spark-gap,  with  which  vacuum  electrodes  are  used 
instead  of  the  metal  electrodes  employed  with  the  static  wave  current 
which  is  administered  in  a   similar  manner. 

Disruptive  Discharges.  Electrical  discharges  which  escape  suddenly  by 
breaking  down   the   dielectric  air-gap;    static  sparks. 


CJLCKSSAKY  255 

Disrupto-coHVictiic  Itischuiffis.  The  static  l>riish-(lischarj;e  whicli  simu- 
lates  botli   the   eonvertive   eHleuve   unil   the   disruptive   or    spark-discharge. 

Dry  Unit.  In  contradistiiution  to  moist  licat,  heated  dry  air  as  used 
in  an  apparatus  designed  for  tlie  indnction  of  hypen'mia,  which  on  aoconnt 
of  dryness  rapidly  absorbs  the  moisture  of  perspiration  from  tlie  skin  in 
the  apparatus  during  the  administration.  A  degree  of  vcntihition  in  the 
apparatus  is  necessary  lest  the  air  become  moist  from  evaporation  of  the 
patient's  perspiration. 

t.'ffiiuvi,  also  fffiure.  A  convective  discharge  of  a  liif:h  potential  cur- 
rent  tlirough  a   dielectric. 

t'.ffluvation.  A  method  of  api>lying  an  iliitrical  discliargt-  in  the  tissues 
by  an  ettleuve  for  the  purpose  of  destroying  redundant  or  diseased  tissue. 

Electricity.  "A  material  agency  which,  when  in  motion,  exhibits  mag- 
netic, chemical  and  thermal  effects,  and  when  at  rest  or  in  motion  e.xcrts 
a  force  upon  other  electricity.  Recent  investigations  indicate  that  it  is 
discrete  or  granular  in  nature  and  there  may  be  two  kinds,  namely 
positive   and    neg-ative." — Shchkni. 

EUctrify.  To  cause  electricity  to  pass  through.  To  charge  with 
electricity. 

Electrize.     To  make  electric.     To  electrify. 

Electro-cautery.  An  apparatus  for  cauterizing  tissue  consisting  of  a 
platinum  wire  in  a  holder  which  may  be  heated  to  a  red  or  white  heat  by 
a  current  of  electricity  when  connected  in  the  circuit. 

Electrode.  A  medium  used  l)etween  an  electric  conductor  and  the  object 
to  which  the  current  is  to  be  applied.  In  electrotherapy  an  electrode  is 
an  instrument  with  a  point  or  a  surface  from  which  to  discharge  current 
to  the  body  of  a  patient. 

Elcctrolciy.  The  department  of  electro-therapeutic  science  which  treats 
of   the    plienomena   and    properties   of   electricity. 

Electrolysis.  The  electrical  decomposition  of  a  chemical  compound  ;  as 
of  the  electrolyte  into  its  constituent  parts  by  an  electrical  current. 

Electrolyte.  A  compound  which  is  deconiposible  or  is  subjected  to  de- 
composition by  an  electrical  current. 

Electro- motive  Force  ( E.  M.  F.)  That  effect  of  difference  of  potential 
which,  upon  closing  a  circuit,  determines  the  flow  of  electricity  from  one 
plait'  to  another,  giving  rise  to  an  electrical  current.  The  strength  of  an 
electrical  current  is  directly  proportional  to  the  electro-motive  force,  and 
invers<Iy  pn)|Mfrtional  to  the  resistance  (Ohm's  law).  f]lcctro-motive  force 
is  measured  in  volts. 

Electron.  A  particle  of  electricity  of  infinitesimal  smallncss,  more  than 
eight  hundred  times  smaller  than  the  atom  of  hydrogen,  from  which  have 
been  rcsolvetl  the  negative  electrons.  It  has  been  maintained  that  there 
are  no  positive  electrons;  but  the  tendency  of  nu)dern  theory  is  to  dis- 
prove this  notion. 


256  GLOSSARY 

Electro-negative.  Repelled  by  bodies  negatively  electrified,  and  attracted 
by  bodies  positively  electrified. 

Electrophorous.  An  instrument  for  obtaining  static  electricity  by  means 
of   induction. 

Electropoion.  A  mixture  of  sulphuric  acid,  bichromate  of  potash  and 
water,  used  as  the  liquid  for  batteries  in  which  zinc  and  carbon  are 
the  elements. 

Electro-positive.  Attracted  by  bodies  negatively  electrified,  and  re- 
pelled by  bodies  positively  electrified. 

Electro-static.     Pertaining  to  static  electricity. 

Electro-therapeutics.     Treatment  of  disease  by  means  of  electricity. 

Eleotro-therapeutist.  A  physician  who  studies  or  practices  electro- 
therapeutics. 

Electrotonic.     Of  or  pertaining  to  electrical  potential. 

Electrotonus.     Of  or  pertaining  to  electrical  potential. 

Frequency.  The  rate  of  oscillation  or  alternation  in  an  alternating 
current  circuit,  in  contradistinction  to  periodicity  in  the  interruptions 
or  regular  variations  of  current  in  a  direct  current  circuit. 

Fulguration.  Destruction  by  flashing  or  sparking  or  similar  applica- 
tion of  electrical  heat.      (See  Effluvation. ) 

Fuse.  A  device  comprising  a  fusible  metal  the  conducting  capacity  of 
which  is  predetermined  and  which  fuses  through  heat  generated  by  the 
passage  through  it  of  excess  of  current.  It  breaks  the  circuit  and  so 
saves  an  apparatus  from  overload.  Convenient  forms  are  mounted  in 
plugs;    or  between  hard  metal   ends  confined   under   screw-heads. 

Galvanic  Current.    That  produced  by  a  chemical  battery. 

High  Frequency.  The  rate  of  alternation  or  oscillation  in  an  alternat- 
ing current  circuit,  exceeding  the  rate  at  which  muscular  contraction 
ceases;    approximately  10,000  per  second. 

Hypertension.  Excessive  tension.  In  medical  usage,  an  arterial  tension 
above  normal. 

Impedance.  The  opposition  to  current  flow  which  is  the  sum  of  ohmic 
resistance  plus   apparently  additional  resistance   due  to  induction. 

Insulation.  The  state  in  which  the  communication  of  electricity  to  other 
bodies  is  prevented  by  the  interposition  of  a  non-conductor;  also,  the 
miaterial  or  substance  which  insulates.  Insulation  is  measured  in  meg- 
ohms. 

Inductance.  The  apparent  resistance  due  to  induction  in  a  circuit, 
.specifically,   to   coefficient   of    self-induction. 

Insulator.  That  which  insulates;  specifically,  a  substance  or  body  that 
interrupts  the  communication  of  electricity  or  heat  to  surrounding  objects; 
a  non-conductor;  anything  through  which  an  electrical  current  will  not 
pass. 


GLOSSARY  257 

Interrupter.  A  mechanical  or  electrolj-tic  device  for  making  and  break- 
ing (closing  and  opening  alternately)  the  low  voltage  direct  current 
circuit  of  the  primary  winding  of  a  KhumkortT  coil  or  other  electrical 
apparatus. 

Inverse  Current,  An  erroneous  expression  for  the  induction,  developed 
in  an  electric  circuit,  in  opposition  to  the  flow  of  the  current  established 
at  the  instant  of  closing  the  circuit. 

Ion.  One  of  the  elements  of  an  electrolyte,  or  compound  body  under- 
going  elect  rolyzation. 

Ionic  .Uedicution.  lonizixtion  or  transmission  of  metallic  or  organic 
ions   into  the   tissues    by   an   electric   current. 

Magnetic  or  Electrical  Field.  The  zone  or  space  within  which  the 
potency  of  these  influences  is  effective. 

Farad.     The  unit  of  st^itic  charge  capacity. 

Milli-am-meter,  or  MilUampcre-meter.  An  instrument  calibrated  in 
milliamperes  to  indicate  the  value  of  small  currents  drawn  from  a 
battery  or  coil,  or  transformer,  usually  for  electro-therapeutic  and  labora- 
tory work.  N.  15. — A  milli-ampere  is  l/lOOOth  part  of  an  ampere,  and 
in  the  scaling  of  meters  for  readings  on  direct  current  circuits  the 
calibration  is  on  this  basis.  But  in  the  case  of  milliampere-meters  for 
indicating  high  frequency  currents  from  resonators  to  subject,  it  must 
l>e  understood  that  the  readings  are  really  the  product  of  relative  current 
strength  and  frequency.  Tlie  indications  are  the  effect  of  temperature 
variations  on  a  wire,  the  temperatures  being  affected  by  the  amotmt  of 
energy  represented  by  the  current.  In  the  standard  Gaiffe  meter  the 
scalings  of  electro-therapeutic  instruments  are  often  arbitrary,  and  there- 
fore, while  they  are  relative  and  useful,  they  are  not  standard. 

Milli-atnperc.     1 /1000th  part  of  one  ampere.      (See  Milliampere-Meter.) 

Modality.  In  therapeutics,  a  method  of  application,  or  employment  of 
any  physical  agent. 

Motor  Generator,  or  Motor  Converter.  Forms  of  a  rotary  machine 
comprising  a  motor  driven  by  electricity  from  an  outside  source,  the 
motor  being  coupled  to  a  dynamo  which  being  driven  generates  another 
oirrent.  The  driving  current  may  be  of  alternating  character  and  the 
g»'ncrate<l  ctirrent  continuous,  or  rice  versa;  or  the  machine  may  be 
uso<l  to  change  the  voltage,  or  amperage,  or  frequency,  or  phase  of  a 
current  by  means  of  differential  windings  on  the  motor  and  dynamo 
respectively.  S<imetimes  a  motor-generatf)r  has  the  differential  windings 
on  one  core   with   two  commutators,  or  sets  of   collecting  rings. 

Morton  Wave  Current,  A  high  potential  static  current  which  may  be 
of  oscillatory  or  pulsating  character  with  intervals  between  succeeding 
oscillations   or    pulsations,    and    rise    and    fall    of   amperage. 

Ohm.  Practical  unit  of  resistance  opposing  current  flow.  The  legal 
ohm   (Paris  Congress  of  1884)    is  the  resistance  offere<l  by  a  column  of 


258  GLOSSARY 

mercury  106  centimeters  high  and  one  square  millimeter  in  cross  section, 
at  0°  C;  about  the  resistance  of  100  meters  of  No.  8  telegraph  wire. 
Ohm's  Law.  The  strength  of  the  current  varies  directly  as  the  applied 
electro-motive  force,  and  inversely  as  the  resistance  of  the  circuit;  or, 
the  current,  expressed  in  amperes,  equals  the  electro-motive  force,  in  volts, 
divided  by  the  resistance  in  ohms  (C=y^ 

Oscillating  Current.  A  current  alternating  in  direction,  and  of  either 
increasing  or  decreasing  amplitude  or  amperage. 

Oscilloscope.  An  instrument,  in  the  form  of  a  vacuum  tube,  used  for 
indicating  by  means  of  light,  produced  when  passing  a  current  through 
it,  whether  the   current  is  unidirectional  or  alternating. 

Oudin  Current.  A  unipolar  current  of  high  frequency  administered 
from  a  solenoid  "  step-up  "  attached  to  one  end  of  a  d'Arsonval  solenoid. 

Parallel  or  Multiple  Arc  Windings,  or  Connections,  are  distinguished 
from  series  connections,  in  that  they  are  individually  and  diractly  con- 
nected from  one  main  conductor  to  the  other  and  are  supplied  with 
current   separately  and   simultaneously  instead  of  successively. 

Periodicity.  The  rate  of  rise  and  fall  or  interruption  of  a  unidirectional 
current,   in  contradistinction  to  the  frequency  of  an  alternating  current. 

Phoresis.  Ionic  transmission  of  bodies,  electro- positive  or  electro-nega- 
tive, into  the  tissues. 

Potential.  The  condition  of  electrical  tension  in  a  body,  manifested 
by  the  production  of  electrical  effects  in  other  bodies  of  different  potential, 
or  in  a  different  state  of  electrical  tension.  When  two  bodies  of  dif- 
ferent potential  are  brought  together  a  current  passes  from  the  high  to 
the  low  potential  until  the  two  are  of  equal  potential,  when  electrical 
action  ceases.  In  common  usage  in  medical  literature  instead  of  voltage 
when  the  electrical  tension  or  pressure  is  high. 

Pulsating  Current.  A  unidirectional  current  with  a  rapidly  varying 
value  in  amperage,  the  rate  of  which  is  designated  periodicity. 

Radiant  Energy.  The  energy  exerted  by  radiating  lines  of  light  in 
the  ether,  comprising  in  therapeutics  the  Roentgen  ray  and  the  visible 
and  invisible  spectrum. 

Resistance.  The  opposing  influence  of  a  body  (solid,  liquid  or  gaseous) 
to  the  expenditure  of  electrical  potential.  It  is  expressed  in  ohms;  one 
ohm  of  resistance  will  permit  the  flow  of  a  current  of  one  ampere  as 
the  result  of  a  pressure  of  one  volt.  The  effect  of  the  expenditure  of 
electrical  energy  in  resistance  is  to  make  it  appear  as  heat. 

Resonator.  A  device  for  increasing  and  regulating  the  potential  of 
oscillations  in  high  frequency  currents;  it  consists  of  a  series  of  open- 
wound  convolutions  of  stiff  wire,  depending  upon  the  air  for  their 
mutual  insulation,  in  series  with  a  condenser  and  a  spark  gap  into 
which    a    high-potential    current    is    passed,    this    causing    interinduction 


GLOSSARY 


259 


between  the  convolutions,  and  increasing  and  diminishing  the  potential 
as  desired.     (See  body  of  work.) 

Rheostat.  A  device  for  introducing  resistance  into  an  electrical  circuit, 
usually  so  construotcil  as  to  permit  of  variations  of  its  effective  value 
by  means  of  a  switch  or  short-circuiting  attiichment.  For  example,  a 
conductor  of  100  olims  resistance  connected  to  a  source  of  100  volts 
applied  potential,  will  permit  a  current  of  1  ampere  to  flow.  To  reduce 
this  current  to  Va  ampere,  the  resistance  of  the  circuit  may  be  increased 
to  200  ohms,  by  inserting   100  ohms  additional   by   means   of  a  rheostat. 

Kheotome.  An  instrument  for  automatically  and  rhythmatically  mak- 
ing and  breaking  a  current:  an  interrupter  with  an  adjustable  speed 
control. 


Fio.    62.     Static   Machine,    Parts   of. 
1,  Pole  Pieces;  2,  Pole  Piece  Washers  and  Nuts;  3,  Rosette;  4,  Slide  Rod 
Balls;   5-6,  Junction  Piece;  7,  I>arge  Balls;   8,  Slide  Rod;  9,  Charger, 
Connector,  Hook,  and  Plug. 


260 


GLOSSARY 


Rhumkorff  Coil.  A  form  of  transformer  of  interrupted  direct  current 
of  a  low  voltage,  to  a  current  of  high  voltage  with  varying  characteristics, 
depending  upon  tlie  make  and  break  of  the  primary  circuit  or  upon  a 
primary  current  of  rapidly  changing  values,  or  upon  other  circuit  con- 
ditions. 

Series  winding  or  connection  is  one  in  which  the  current  traverses 
the  conductor  sections  and  translating  devices  successively. 


A    B 


Fig.  63.  Parts  of  Static  Machine. 
A-F,  Stationary  Supports;  B-G,  Comb  Holders;  C,  Window  of  Machine 
or  Vertical  Space  between  Stationary  Plates;  D,  Shaft;  E,  Neutraliz- 
ing Rod;  H,  Long  Comb  Holder  Supports;  I,  Straight  Plates;  J,  Gilt 
Papers  Armature;  K,  Short  Comb  Holder  Supports;  L,  Stationary 
Uprights;  M,  Stationary  Support  Washers;  N,  Charger  Xeutralizers ; 
0,  Charger  Brush  Holders;  P,  Charger  Hub  Nut;  Q,  Charger  Gears; 
R,  Charger  Comb  Holders;  S,  Charger  Brush  Holder  Supports;  T, 
Shaft;    U,  Charger   Hubs. 


GLOSSAKY  261 

Hhurt  Circuit.  Cutting  out  the  whole  or  a  bection  of  an  ek-ctrii-  linuit 
by  bridging  it  by  a  path  of  relatively  low  resistance.  Wlicii  a  oinuit 
is  bridged,  and  that  part  of  it  beyond  the  bridge  rendered  dead,  tlie 
bridge  is  called   a   dfud  short-circuit. 

Sinusoidal  Current.  An  alternating  current  diagrammatioaliy  indi- 
cnte<i   by   a    true   sine   wave  curve. 

Spttrfc  (iaps.  Arrangement  of  points  or  surfaces  between  which  a  spark 
of  electricity  uuiy  jump.  An  adjustable  gap  between  needle  points,  is 
used  as  a  measure  of  very  high  p<itentials.  The  A.  I.  E.  K.  standard 
is   50,000   volts   for  the  first  inch   in   dry  clear   air. 

Testa  Current.  A  current  of  enormous  frequency,  very  high  voltage 
but  very  low  amperage,  administered  through  one  conductor  with  earth 
r«turn.      (See  bo<ly  of   work.) 

Transformer  (or  ISIatic  Transformer).  A  static  device  consisting  of 
two  insulated  windings  on  an  iron  core,  for  changing  by  induction  the 
ratio  of  voltage  and  amperage  of  alternating  currents  (only).  An  ideal 
(lOO^o  etiiciency)  transformer  having  its  primary  and  secondary  windings 
proportioned  in  the  ratio  of  1  to  1000,  would  change  a  primary  cur- 
rent of  100  volts  and  10  amperes  transmitted  to  its  primary,  into  a 
secondary  current  of  100,000  volts  and  10  milliamperes.  A  closed-niag- 
netic-transformer  is  one  in  which  the  iron  magnetic  core  is  formed  into 
an  unbroken  iron  circuit. 

Unidirectional.     In  one  direction. 

Unit.  The  commercial  term  used  to  express  the  value  of  electricity 
in  terms  of  voltage  multiplied  by  amperage  multiplied  by  time:  thus, 
100  volts  X  10  amjjeres  x  1  hour  equals  1  unit;  or  200  volts  X  5  amperes 
X  5  hours  equals  .3  units.  This  is  the  basis  on  which  commercial  cur- 
rents  are   metered. 

Unipolar.     Of  one  polarity,  not  alternating. 

Valve  Tube.  A  device,  in  the  form  of  a  vacuum  tube,  for  damping 
out  alternate  (oppose<l)  half-waves  from  a  current  which  it  is  desire<l 
to   render   truly   unidirectional. 

Volt.  Tlie  unit  of  pressure  or  electro-motive  force  impressed  upon  or 
applied  to  a   circuit,  and   tending  to  produce  a  current. 

Voltage.  Difference  of  electrical  potential;  the  analogue  of  difference 
of   pressure  in   hydrostatics  or  hydraulics. 

Voltmeter.  An  instrument,  calibrated  to  indicate  volts  of  potential 
difference  between  the  points  in  the  circuit  at  which  it  is  connected. 

\yatt.  The  product  of  the  voltage  by  the  amperes.  With  a  110  volt 
current  of  5  amperes  we  have   110  volts   X   5  amperes  equals  550  Watts. 


INDEX 


Abdominal  orpans,  atony  of,  224 

conjji'stion  of,  214 
Abdominal  walls  relaxed.  226 
Abscess  of  the  liver,  treatment  of.  242 
Abscesses,   cold,   cffect^s   ne;,'ativc,   243 
cold,  profjnosis  bad  in.  24:5 
treated  by  resonator  sparks.  70 
Acid  lactic  ferments  in  hypertension, 

165 
Acne,  convective  discharges  in,  51 
Adenitis,   tubercular,    high    frequency 
currents  in,  242 
Roentgen  ray  in.  244 
treatment  of,  244 
Alternating    current,    apparatus    for 
use  with,  100 
apparatus,  old  type,  75 
Analgesic  effect  of  vacuum  tube  dis- 
charges, 64 
Anesthetic  areas  in  locomotor  ataxia, 

188 
Angiomas       treated       by       rcsonatt)r 

sparks,  69 
Ankle,  sprained,  case  report,  208 

sprained,  treatment  of,  203 
Ankylosis,  Nature's  metho<l  in  curing 

"arthritis.  211 
Anterior    poliomyelitis,    atrophy    pre- 
vented, 187 
indications  for  treatment.  185 
length  of  spark  gap  in,  186 
massage  in,   187 
mechanical  vibration  in,  187 
prognosis,  187 

radiant  light  and  heat  in,  185,   187 
treatment  of,  184.   186 
treatment  of  acute  stage,  185 
Antiseptic    action    of    high    potential 

discharges.    157 
Anus,  fir.su re  of,  232 
Apparatus,  different  types  of,  85 
for    d'Arsonvali/ation.    test    of    ef- 
ficiency of.  177 
portable,  so  calieil  Tesia,  122 
Apoplexy  averted  by  treatment  of  hy- 
pertension,  168 


Apoplexy,    d'Arsonvalizaticm    in,    182 
prophylactic  treatment  of,  182 
radiant  light  and  heat  in,   182 
treatment  of,  182 
Appendicitis,  acute,  treatment  of,  247 

chronic,   treatment  of,  247 
Argyll- Robert  son  jmpil   in  tabes  dor- 

salis,    l!tO 
Arrangement     for    employing    direct 

d'Arsonvalization,    11!) 
Arterial  condition  must  be  regulated 
to  exercise,   175 
degeneration,    159 
tension,  effects  of  wave  current  on, 

14 
tension,  high,  compensatory,  173 
tension,  high,  not  affected  in  most 

advanced  cases,  167,  168 
tension,  influences  which  raise,   160 
tension   in  parenchvmatous  nephri- 
tis,  173 
tension,  normal,  163 
Arteriosclerosis,  advanced  cases  may 
not  be  affected  by  d'Arsonvaliza- 
tion, 167 
hypertension  cause  of,  159 
in  patients  from  60  to  70  years  of 
age,  167 
Arthritis,  gonorrheal,  211 

gonorrheal,  treatment  of,  245 
infectious,    called    rheumatism,   211 
inf(>ctious.    Roentgen    ray    in    treat- 
ment of,  244 
infectious,  treatment  of.  244 
Nature's  nietlifMj  in,  211 
tul>ercular.  Roentgen  ray  in  treat- 
ment of,  244 
tul)er(ular,  treatment  of,  211,  244 
Atonic  conditions,  d'Arsonval  current 
in.  226 
radiant   light  and  heat  in,  226 
treatment  of,  226 
Atony,  gastric,  treatment  of.  226 

intestinal,  treatment  of,  226 
Author's  spark  director,  35 


I 


263 


264 


INDEX 


Auto-condensation  couch,  types  illus- 
trated, 113,  114 
in  hypertension,  165 
methods  considered,  112 
method  of  using,  115,  116 
terminology    not    distinctive,    112 
Auto-conduction,  action  of  current  in, 
119 
by  static  method,  120,  179,  180 
efficient,  but  not  convenient,  179 
method  of,  178 

method  of  administration,  119 
method   of   controlling   current   in, 

179 
method  of  employing,  177 
nutritional  effects  of,  179 
terminology  not  distinctive,  112 

Ball,    author's    pear-shaped,    for    ad- 
ministering static   sparks,  39 
Bishop,  Dr.  Francis  B.,  71,  129 
Bladder,  dilated,  in  locomotor  ataxia, 

190 
Blood,  effects  of  high  frequency  cur- 
rents on,   65 
effects  of  radiant  energy  upon,  65 
pressure,  effects  of  d'Arsonval  cur- 
rent on,  132 
pressure     effects    of   wave    current 

on,  132 
pressure,  normal,  163 
pressure,  variations  in  sexes,  163 
Boils,  convective  discharges   in,  51 
direct  vacuum  electrode  current  in, 

239 
treatment  by  hyperemia,  240,  241 
Brachial    neuritis,    static    sparks    in 
treatment  of,  37 
wave  current  in  treatment  of,  196 
Brain,  cells,  degeneration  of,  182 
syphilitic  lesions  of,  183 
treatment  of  lesions  of,  182 
tumors  of,  183 
Bruises   of   female   breast,   treatment 

of,  234 
Brush  discharge,  administered  in  the 
cavities  of  the  body,  52 
arrangement  for,  43 
caution  in  use  of,  45 
compared  to  the  static  spray,  42 
disrupto-convective,   43,  44 
electrode  moistened  for,  44 
electrodes  for  administering,  43 
irritating  and  rubefacient,  16 
method  of  administration  of,  43,  44 
speed  of  machine  with,  45 


Brush     discharge,     static,    in     facial 
neuritis,  197 
term  not  distinctive,  42 
Burch,   Dr.   J.   H.,    130 

Caldwell.  Dr.  E.  W..  88 
Cannon,  Dr.  T.  H.,  Electrode  of,  250 
Cardiac      compensation       inadequate 
with   dilatation,   171 
dilatation  rare  in  hypertension,  169 
dilatation  with  hypertrophy,  171 
dilatation  without  hypertrophy,  171 
hypertrophy  in  athletes,  with  dila- 
tation, 171 
hypertrophy  in  hypertension,   169 
Carbuncles,  treatment  of,  239 
Caruncles,  urethral,  treatment  of,  216 
Cataphoric    action    of     vacuum     dis- 
charges, 71 
Cathode  rays,  56 

source  of,  60 
Cauterizing   effect   of   high    potential 

discharges,  62,  63 
Cell    protoplasm,    contraction    of    by 

static  current,  133 
Cellulitis,  pelvic,  treatment  of,  247 
Centrifugal  interrupter,  87 
Cerebral    hemorrhage,    mild   galvanic 

current  in,  182 
Cervix,  brush  discharge  to,  52 
Cliaracteristics  of  electrons,  55,  56 
Chemical     effects    of    electrical    dis- 
charges, 60,  61 
Chilblains,  treatment  of,  232 
Chorea,  a  functional  neurosis,  201 
case  cited,  204 
major,  treatment  of,  192 
theory  of  treatment,  205 
treatment  of,  192,  203 
Circulatory    system,    high     potential 

currents  in,  159 
Cirrhosis  of  the  liver,  hypertrophic, 

treatment  of,  225 
Cirrhotic    liver,   treatment   by   static 

wave  current,   172 
Clarke,  Mr.  Chas.  L.,  76 
Dr.  Wm.  L.,  249 

Dr.  \Ym.  L.,  method  by  oscillatory 
desiccation,  249 
Closed  magnetic  circuit  transformer, 

92 
Coil,  eflBeuve,  character  of  discharge, 
46,  47 
for  resonator  currents  with  vacuum 

tubes,   66 
Rhumkorff,  85 


INDEX 


265 


Color  cfTccta  in  vaouum  electrodes,  5!> 
Comparison   of   iinrtMits  of   liij^li    fre- 

queni-y  ami  hijjli  poriotiii-ity,  7.'} 
Condensor    metal    for    auto-eondenaa- 

tion  coueh,   1 14 
Condensors.  tvpes  of,  illustrated,  106 
Condiot,  Dr.  Alice  B..  2J-> 
Confusion  concernin;;  iiijlh   frequency 

nnxlalities.   70 
Congestion,   acute,   wave   current    in, 
IS),  20 
effects  of  wave  current  on.  20 
effects  of   vacuum   tube  discharges 

on,  64,  65 
of  the  tear  ducts,  treatment  of,  230 
ovarian,  treatment  of,  216 
superficial  effects  of  vaccum  tubes, 
67,  68 
Constipation    in    children,    treatment 
of,  226 
static  wave  current  in,  226 
Contraction  of  cell  protoplasm,  12 
muscular,  and  tissue  with  vacuum 

tul)e  disi'harges,  65 
muscular,  causes  of  varicocele,  223 
muscular,  in  neuritis.   196 
muscular,  in  hx-omotor  ataxia,   188 
muscular,  wave  current  in,  23 
Contusions,  treatment  of,  234 
Convective   discharges   antiseptic   ac- 
tion of,  48,  40 
character  of,  41 
defined,  42 
in  lK>ils,  50 

in  felons  (whitlows),  50 
in  local  stasis,  49.  50 
in  skin  diseases,  51 
over  ulcerated  surfaces,  51,  52 
physiological  action  of,  47 
Cooper- Hewitt  rectifier,  103 
Cord,  diseases  of,   static   current   in, 

183 
Corneal   ulcers,  treatment  of.  220 
Current,    condensation     in     body     in 
auto-condensation,  117 
d'Arsonval    becomes    unidirectional 

under  cH»rtain  conditions,  77 
direction,   235 

effects  of  wave  in  anterior  poliomye- 
litis.   186 
of    high    frequency   and   high    peri- 

o<licity   compared,   73 
of  one  polarity,  action  of,   13 
pulsatory,  purest   type,  77 
quality  varies  with  source,  83 


Current,  transformation,   methods  of, 
101 
variations  controlled,  83 
of  .litfcniit  potential.  127 
general  diffusion  of,  i;{0 
Currents  of   high    perio<licity,   effects 
produced   by,  83 
of  low  potential,  inelliciency  of,  206 
of  one  polarity,  action  of,  13 
of  one  polarity,  vacuum  discharges, 
63 
Cushion  for  auto-condensation  couch, 
construction  of,  114 

d'Arsonval,   and   static    wave  current 

compared,  130 

biiKilar,  direct  method  in  treatment 

of    infectious    arthritis    current, 

79.  80 

current,  and    static    wave    current 

compared,   77 
current,  arrangement  for,  76 
current,  author's    method    of    em- 
ploying. 178 
current,  contraindicated    in    paren- 
chymatous nephritis,  170 
current,  direct,  dosage  of,  242 
current,  direct,  in  appendicitis,  247 
current,  direct,  in  cellulitis,   247 
current,  direct,  in  gonorrheal  arth- 
ritis, 246 
current,  direct,  in  infections  of  the 

mesentery.   248 
current,  direct,  in  intestinal   infec- 
tion. 247 
current,  direct,  in  pelvic  cellulitis, 

247 
current,  direct,  in  pyosalpinx,    247 
current,  direct,  in  salpyngitis.   247 
current,  direct,  in  treatment  of  In- 
fection, 240 
current,  direct,  in  tul)ercular  aden- 
itis, 244 
current,  direct,  metho<l  in  adenitis, 

242 
current,  direct,  method     of     induc- 
ing hyperemia,  241 
current,  direct  metho<l,  thermic  ef- 
fects of.  241 
current,  effects  of,  118 
current  efTects  upon  blood  pressure, 

132 
current  for  eflluvation,  124 
current   in  atonic   conditions,    226 
current   in  hypertension,  174 
current  low  potential  of,   116,  130 


266 


INDEX 


d'Arsonval,  current  method  in  acute 
and  chronic  appendicitis,  247 
current  method  of  employing,  177 
current  polar  eflfects  of,  147 
direct  method    of    inducing    hyper- 
emia, 156 
direct  method  in  pyogenic  adenitis, 

242 
direct  method  in  treatment   of   tu- 
berculosis, 24.3 
direct  method  in  tubercular  adeni- 
tis, 242 
Prof.,  76 

Tesla    and    Oudin    currents    com- 
pared, 79 
with  vacuum  electrodes,  239 
d'Arsonvalization,  112 
causes  general  glow,  176 
direct  methods  of,  112 
does  not  depress  heart,  166,  176 
effect    upon    blood     pressure     pro- 
nounced,   176 
fall  of  arterial  tension  from,  170 
in  early  hypertension,  170 
objections  to   electrolytic   interrup- 
ter, 88 
test   of   efficiency   with    apparatus, 

177 
variations  in  effects  of  different  ap- 
paratus, 177 
Deep  seated  conditions,  bipolar  direct 
d'Arsonval  current  in,  247 
wave  current  in,  20 
deKraft,  Dr.  Frederick.  226 

method  in  diahetis  mellitus,  226 
method  of,  122 
Desiccation,    oscillatory,    method    of 

Clarke,  249 
Detonating    chamber,    proper    dimen- 
sions for,  111 
Diahetis      mellitus.      Dr.      deKraft's 
method  in,  226 
treatment  of,  225 
Diet  regime  in   hypertension,   174 
Diffusion  of  electrical  current,  130 

static  wave  current,  9 
Digestion,  effects  of  wave  current  up- 
on, 16 
Dilated  bladder,  treatment  of,  190 
Direct    d'Arsonval    current   in   gonor- 
rheal arthritis,  242 
d'Arsonval   in  treatment  of  abscess 

of  the  liver,  242 
d'Arsonval   in  treatment  of  appen- 
dicitis, acute,  242 


Direct    d'Arsonval    in    treatment    of 
appendicitis,  chronic,  242 

d'Arsonvalization  method,   120 

static  vacuum  current  in   epididy- 
mitis, 223 

static  vacuum  current  in  fissure  of 
the  anus,  231 

static  vacuum  current  in  glaucoma, 
230 

static  vacuum  current  in  post-nasal 
ulcers,  231 

static  vacuum  current  in  treatment 
of  pterygium,  229 

static  vacuum  current  in  ulcers  of 
the  rectum,  232 

vacuum  tube  current  in  acute  epi- 
didymitis, 246 

vacuum  tube  current  in  congestion 
of  the  nasal  passages,  231 

vacuum  tube  current   in  fissure  of 
anus,  233 

vacuum  tube  current  in  glaucoma, 
230 

vacuum  tube  current  in  post-nasal 
ulcers,  231 

vacuum   tube  current  in   ulcers   of 
the  rectum,  232 
Direction  of  current,  235 
Discharges,  cauterizing  effect  of,  62, 
63 

interrupted,    in    inflammatory   con- 
ditions, 47,  48 
Diseases  of  the  cord,  static  currents 

in,  183 
Dislocations,  treatment  following,  234 
Disruptive  discharges,  53 
Dysmenorrhea,  in  subinvolution,  211 

treatment  of   by   author's   method, 
212 

treatment   of,   discoverv   of   bv   au- 
thor, 199 


Eating,  excessive,  cause  of  hyperten- 
sion, 164 
Echymosis,  static  brush  discharge  in 

treatment  of,  234 
Eczema,  convective  discharges  in.  51 

treated   by  resonator   sparks.   69 
Effects  of  currents  of  great  potential 
and  large  quantity,  128 
of  discharges   on  end   organ  meta- 
bolism, 50 
of  vacuum   discharges   upon   exces- 
sive secretion,  70 


INDEX 


267 


Effects    of    viu'iium    discharges    upon 
induration   and    >*\velliny,  70 
of   vacuum   discharges   upon    secre- 
tion, 69,  70 
of  vacuum  iliscliarges  upon  tissue 

repair,  70 
of  vacuum  tubes  in  superficial  con- 
gestion. 67,  68 
phvsical    of    electrical    discharges, 

125 
physical  of  electricity,  126 
physiological,  of  vacuum  tube  dis- 
cliarges    upon    diminished    secre- 
tion, 69 
rubefacient,  vacuum  discharges,  62 
upon  general  metabolism  of  vacuum 

tiischarges.  (U.  (i.l 
vacuum  discharges,  01 
various  of  electrical  currents.  128 
EflBuvation,  electrode  of  Dr.  Cannons, 
250 
method  of  employment.  249 
or    fulguration    bv   Oudin    current, 

124 
tcclinique   of,   250 
Effleuve  from  coil,  41,  46 
from  the  static  machine,  41 
or  iH>nvective  discharges,  41 
Electrical  current,  diffusion  of,   130 
Electrical  discharges,  physical  effects 
of,   125 
discharges,  radiant  energA*  of,  158 
treatment,  exceptions,  175 
Electricity,  for  treating  nephritis,  169 

physical  effects  of,  126 
Electrmle  for  auto-condensation,    115 
metallic,   for  treating  parenchyma- 

t<ius  nephritis,   172 
Wappler,   fulgurating,  251 
Electrodes   for   post-nasal   treatment, 
231 
for   treatment  of    fissure    in   anus, 

233 
glass   vacuum   in    mucous   cavities, 

234 
in  the  treatment  of  subinvolution, 

214 
nasal,  230,  231 

regulation   of   size   with   wave   cur- 
rent, 20 
Electrolysis  in  endometritis,  214 
Electrolytic  interrupter.  H~ 

disadvantage   of  for   d'Arsonvaliza- 

tion,  88 
rectifier  illustrated,  104 


Elect rt>ns.  characteristics  of,  55 

negative,  57 
Elimination  by  *he  wave  current,  13, 

14 
Endometritis,  treatment  of,  by   Mas- 

sey's  nicthdd,  213 
End    orgini    nietjilxilism     effected     by 

convective  discharges,  50 
Epididymitis,  metliod  of  treating,  223 
teclnii(|uc   of  treatment,  223 
treatment  of,  223 
Epilepsy      fiiiictional,     a      functional 
neuroses,  201 
indications  in,  202 
treatment  of.  202 
Examination    for   life    insurance   dis- 
covers hypertension,  170 
Excessive  eating,  cause  of   hyperten- 
sion,  174 
Exercise,   effects   on    blood    pressure, 
160 
efFects  upon  tlie  heart,  100 
in   iiypertension,   164 
metliod    in   tabes,   Fraenkel's,   189 
must   be   regulated  to  arterial  con- 
dition,  175 
regulation  of  in  hypertension,   175 
Exudates,  inflammatory,  wave  current 
in,  21 
sparks  in,  21 

Fatigue   from   administration   of   the 

wave  current,  16 
Fauces,  brush  ilischarge  to,  52 
Favus,  convective  discharges  in,  51 
Felons     (whitlows),    convective    dis- 
charges in,  50 
treated  by  resonator  sparks,  69 
treatment  of,  23!) 
Field    of    application    determined    by 

conditions,  39,  40 
Food  in  excess  cause  of  hvpertension, 
164 
quantity  to  be  diminished  in  iiyper- 
tension. 175 
to  be  regulated  to  exercise,  164 
Foot,    severe    injury   of,    case   report, 

235 
Fractures,   treatment  following,  234 
Fnienkel,  Dr..  189 
Fraenkel's,   Dr.,   exercise   methods  in 

talx's,  189 
Fre(|iicncy.  consideration  of,  2 
eftects  upon  phenomena  in  vacuum 

tubes,   59.  60 
increases  heat  production,  177 


268 


INDEX 


Fulguration,  method  of  employment, 
249 
indications  for, 
technique  of,  250 
Functions,  special,  effects  of  wave  cur- 
rent on,  24 
Furuncles,  treatment  of,  239 

General  metabolism,  effects   of  d'Ar- 

sonvalization  on,  132 

effects  of  vacuum  discharges  on,  64 

effects  of  wave  current  on,  132,  144 

Germicidal    action   of   high   potential 

discharges,  157 
Glass  sleeves  for  administering  brush 
discharge  in  the  cavities,   52 
negative  electrons  pass  through,  57, 
58,  59 
Glaucoma,  case  report,  230 

treatment  of,  230 
Gonorrlieal  arthritis,  high  frequency 
currents  in,  245 
arthritis,    technique   of    treatment, 

245 
arthritis,  treatment  of,  245 
infection,   treated   by   direct    d'Ar- 

sonval  high  frequency,  242 
rhetimatism,      wave      current     not 
adapted  to,  22 
Grounding  chain,  8 

Hay  fever,  treatment   of,  232 
Heart,  effects  of  exercise  upon,  160 
not  depressed  by  d'Arsonvalization, 
176 
Heat   production,   increased   with   in- 
crease of  frequency,  177 
wave  current  effects  in,  14,  15 
with  vacuum  electrodes,  67 
Hemorrhage,  cerebral,  182 
Hemorrhoidal    electrode.    Dr.    Arnold 

Snow's,   232,   233 
Hemorrhoids,   treatment  of  by  static 
current,  233 
treatment  following  operation,  233 
Herdman,  Dr.  William  J.,  179 

experiments  of  with  high  frequency 
currents,    179 
Herpes,  convective  discharges  in,  197 
of  the  scalp,  197 
zoster,   radiant   light   and  heat  in, 

197 
zoster,    static    brush    discharge   in, 
197 
Hewitt,  Cooper,  rectifier,  103 


High  frequency  apparatus,  complete, 

illustrated,   107 
High  frequency  currents,  cataphoresis 
with,  129 

currents,  comparison  of,  73 

currents,  defined,  74 

currents,  hyperemia    produced    by, 
83 

currents,  in  adenitis,  tubercular  or 
streptococcic,   242 

currents,  in  gonorrheal      arthritis, 
246 

currents,  in  treatment  of  abdomin- 
al conditions,  248 

currents,  in  treatment  of  chest  dis- 
eases, 248 

currents,    in    treatment    of    pelvic 
conditions,  248 

currents,  rates  of,  74 

currents,  superficial  in  effect,  56 

currents,  thermic  effects  of,  56,  148 

currents,  variations  with,  82 

direct  d'Arsonval  in  the  treatment 
of  gonorrheal   infection,  242 

direct  d'Arsonval  in  the  treatment 
of  pelvic  cellulitis,  242 

direct  d'Arsonval  in  the  treatment 
of  salpyngitis,  242 

modalities,  confusion  concerning,  79 

renders  currents  safe,  128 

resonator,  105 
High    periodicity   current,    how    pro- 
duced, 76 

potential  currents,  cauterant  effects 
of,    129 

currents,  contrasted,  127 

currents,  electolytic  action  of,   129 

currents  in  diseases  of  the  circula- 
tory system,  159 

currents,  one  pole,  universally  dif- 
fused, 127 

discharges,  antiseptic  action  of,  157 

rotary  rectifier,  93,  94 

rotary  rectifier,  illustrated,  93 
Hot  air  baths  dry,  in  parenchymatous 
nephritis,   173 

in  effects  upon  deep  reflexes,  173 
Humidity,  periods  of,  31 
Humphris,  Dr.  Francis  H.,  43 
Hyperemia,    does    not   relieve    stasis, 
240 

effects   of  the   wave   current  upon, 
17,  18,  19 

effects  on  metabolism,  240 

effects  upon  nutrition,  240 

induced  by  vacuum  tubes,  239 


INDEX 


269 


Hyperemia,   in   infection,   ln"> 
methods  of  inducing,   156 
physiological  efTects  of,  240 
Hyperemic  efTocts  of  currents  of  high 

frequency,  83 
of  ciirrents  of  high   periodicity,  83 
Hypertension,    auto-condensation     in, 

165 
cardiac  dilatation  with,  169 
causes  of,   164 

causo  of  arteriosclerosis,  159 
classification  of  cases,  166 
compensatory      controlled,      averts 

apoplexy,  168 
d'Arsonval  current  in,    174 
diet  regime  in,  174 
discovered  often   by   examiners   for 

life  insurance.    170 
early  cases  of,   170 
electrical  treatment  of,  165,  175 
excessive  eating  cause  of,  164 
in  aged  and  feeble  people,  167 
in  athletes,  170 
indications  for  treating,  174 
modus    operandi    of    current    influ- 
encing, 176 
nephritis  not  present  early  in,   169 
quantity  of  foixl  in,  174 
regulation  of  diet  and  exercise,  164, 

175 
rules  for  employing,  178 
treatment  of,  174 
Hysteria,  a    functional   neuroses.  201 
of    physical    origin,   a   case    report, 

198" 


Inertia,  wave  current  in,  24 
Infection,  hyperemia  in  treatment  of, 
240.  241 
local,  indications  for  treatment,  237 
meth<xl  of  treating,  156,  157 
radiant  light  and  heat  in  treatment 

of,    157 
Roentgen  ray  in  treatment  of.  1.56 
treatment  bv  direct  d'Arsonval  cur- 
rent, 240' 
treatment    by    high    frequency   cur- 
rents, 238* 
treatment  by  vacuum  electrode  dis 
charges,  239 
Infectious  arthritis.  Roentgen  ray   in 
treatment  of,  244 
arthritis,  treatment  of,  244 
conditions  of  the  mesentery,  248 
diseases,  treatment  of,   155 


InfectioJis     inflammation,     conditions 
which   favor,   237 
inflammation.      Roentgen      ray      in 

treatment  of,  238 
inflammatory  process,  236 
Inflammation,    infectious,    conditions 
favoring.  237 
inf<'('tious.  high  frequency  currents 

Ui   treatment  of,  237 
infectious,     indications     for     treat- 
ment, 237 
infectious,  treatment  of,  236 
infect ious.varieties  of,  236 
non- infected,  therapeutics  of,  206 
process  of   infection,  236 
Inflammations,  pelvic,  211 
Inflammatory    condition,    interrtipted 

discliarges  in,  47.  48 
Influences    which    raise    arterial    ten- 
sion. 160 
Interrupter,  Caldwell,  88 
centrifugal,  illustrated,   87,  90 
electrolytic,  87 
mechanical,  illustrated.  91 
mercury  jet.  types  of,  87,  89 
Wehnelt,  87 
Interrupt eriess  transformers,  92 

illustrated,  93 
Interrupters.  ditTerent  types  of,  87 

mechanical,  87 
Irritation,  vesicle,  treatment  of,  218 

■lenks.    Mr.    \Vm.   J.,   76 

K acting- Hart,  Dr.,  84 
fulguration  of.  249 
Kennelly,  Dr.  A.  E.,  73 

Leyden   jars,   arrangement    for   static 
induced  current,  31 
use  of  difTerent  sizes,  68 
use  of  dilTercnt  sizes  for  static  in- 
duced current,  67 
varied    acccuding   to  ofTect,   69 
Liglit  and  heat,  radiant,  in  mastoidi- 
tis, 241 
in  otitis  media,  241 
in  suppurative     processes     of     the 

frontal   sinuses,  241 
in   treatment  of  apoplexy.   182 
in  treatment    of    suppurative    pro- 
cesses, 241 
Light    baths,   electrical,    in    parenchy- 
matous nephritis,   173 
Lo<-nl  stasis,  elTecta  of  convective  dis-/ 
charges  on,  49,  50 


270 


INDEX 


Local   stasis,  vibration  of  tissues  in- 
duced    by     vacuum     tube     dis- 
charges, 65 
Ix)comotor  ataxia,  anesthetic  areas  in, 
188 

Argyll  Robertson  pupil  in,  190 

causes  of,  187 

dilated  bladder  in,  190 

girdle  sensation,  treatment  of,  189 

indications  for  treatment,  188 

pathology  of,  187 

prognosis  of  treatment,  190 

static  sparks  in,   188 

static  wave  current  in,  188 

symptoms  of,  188,  189 

systematic  execise  in,  189 

treatment  of  anesthesia,  188 

treatment  of  pains  of,  189 

treatment  of  walk  in,  189 
Lodge,  Sir  Oliver,  56,  59 
Low  potential  of  d'Arsonval  current, 

130 
Lupus  vulgaris,  convective  discharges 
in,  51 

erythematosis,        convective       dis- 
charges in,  51 

treated  by  resonator  sparks,  69 

treatment  of  by   static  brush   dis- 
charge, 228 

treatment  of  by  x-ray,  228 

Malignant   diseases  to   be  considered 

in  treatment  of  prostatitis,  221 
Massage  in  anterior  poliomyelitis,  187 
Massey,  Dr.  G.  Betton,  213 
Mastoiditis,  treatment  of,  241 
McCaa  transformer,  94,  95 

illustrated,  95 
Mechanical    interrupters,    advantages 

of,  87,  91 
Mercury   jet   interrupter,   87 
Metabolism,  effects  of  d'Arsonvalizn- 
tion  on,  132 
effects  of  hyperemia  on,  240 
effects  of  vacuum   tube   discharges 

on,  64 
effects   of  wave   current  on,   13 
wave  current  in,  errors  of,  23,  24 
Metchnikoff,  Dr.,  155 

method  in  hypertension,  174 
Meter,  hot  wire,  115 

illustrated,  116 
Middle  ear,  brush  discharge  to,  53 
Milliamperes,   400   to    500   for    d'Ar- 
sonvalization,  176 


Morton,   Dr.   William  J.,   static  cur- 
rents of,  75 
Motor  dynamo  for  transforming  cur- 
rent, 102 
Mucous   cavities,   treatment  by  glass 

vacuum   electrodes,   234 
Muffler  for  use  with  wave  current,  20, 

21 
Multiple    point    electrode    for    static 

spray,  42 
Muscular   contraction  as   induced  by 
various   currents,   compared,   133 
contraction   treatment  of   in   arth- 
ritis, 210 
spasm  and  the  wave  current,  23 
spasm  contraction  produced  by  res- 
onator sparks,  69 
spasm  relieved  by  static  sparks,  37 
spasm  static  sparks  in  the  treat- 
ment of,  38 
spasm    tension    relieved    by    static 
sparks. 
Myelitis,  transverse,  treatment  of,  191 

Nature's  method,  ankylosis,  211 
Nasal  passages,  congestion,  treatment 

of,  231 
Neoplasm   destroyed  by  direct  d'Ar- 
sonval, 4 
Nephritis,  electricity  for  treating,  169 

interstitial,  treatment  of,  225 

not  present  in  early  hypertension, 
169 

parenchymatous,  d'Arsonval  auto- 
condensation  contraindicated  in, 
170 

parenchymatous,  electric  light 
baths  in,  173 

parenchymatous,  high  frequency 
contraindicated  in,  172 

parenchymatous,  hypertension  in, 
172 

parenchymatous,  length  of  spark- 
gap  with  wave  current  in,  172 

parenchymatous,  light  baths  in,  173 

parenchymatous,  treatment  by  sta- 
tic wave  current,  169 

parenchymatous,  treatment  of,  225 

static  wave  current  in,  169,  172 

treatment  of,   169 
Nerves    not  best   conductors   of   elec- 
tricity,  126 
Nervous  system,  central,  181 

diseases,   classification  of,   181 

diseases  of,   181 


INDEX 


271 


Nervous  diseases,  effects  of  wave  cur- 
rent on,  14 

iuJlanmiatory  affections  of,  181,  183 

irritability  wave  current  in,  23 

mental  derangements  of,  181 

peripheral  affections  of,  193 

therapeutic   indications   in  diseases 
of,   181 
Neuralgia,   for   neuritis,  a  misnomer, 

193 
Neurasthenia,  a  ease  cited,  198 

a  functional  neuroses,  201 

prostatitis  in,   198 
Neuritis,  brachial,  treatment  of,   196 

causes  of,  194 

common  sites  of,  194 

consideration  of,  193 

diagnosis  of,  193 

facial,  treatment  of,  197 

intercostal,  196 

localization  of,  193 

muscular  contractions  in,  196 

prognosis  in,  194 

static  current  in,  196 

technique  of  treating,  196 

treatment  of,  194.  195.  196 
Neurologists'   attitude  towards  func- 
tional neuroses,   199 
Neuroses,        functional.        Christian 
Science  in,  200 

diet  and  exercise  in,  202 

differentiation  of,  201 

exercise  and  diet  in,  202 

inherited,  200 

management  of,  200 

not  of  psychic  origin,   197 

neurologists'  opinion  of,  198 

prognosis  in,  202 

psychic  healing  in,  200 

psychopathic,  197 

treatment  of,  201,  203 
New  types  of  transformers,  99 
Nitrous  oxides  and  ozone  action  Qpon 
germa,  157 

Obstruction  of  tear  ducts,  treatment 

of,  230 
Ohmic  rheostat  illustrated,  101 
Orchitis,  treatment  of,  223 
Oscillatory  currents,  74 

desiccation,  method  of  Clark,  249 
Osteo-arthritis,  treatment  of,  211 
Otitis  media,  treatment  of,  241 
Oudin  current,  123 

by  Dr.  deKraft's  method,   124 


Oudin,  d'Arsonval  and  Tesla  currents 
compared,  79 

de.scribed,  81,  82 

for  elHuvation  or  fulguration,   124 

Prof.,  123 
Ovarian  congestion,  treatment  of,  216 
Ozone,  action  upon  germs,  157 

Pachymeningitis,  treatment  of,  192 
Pain    relieved    by   the   wave    current, 
22,  23 
relieved  by  vacuum  currents,  72 
Paraplegia,  spastic,  treatment  of,  191 
Pelvic    cellulitis,    treated    by    direct 
d'Arsonval   high   frequency,   242 
treatment  of,  242 
Phagocytosis,  conditions  which  lower, 
237 
increased  by   hyperemia,   155 
Phenomena    of    the    passage    of    the 
negative  electrons  through  glass, 
57,  58,  59 
effects  of  frequency  on,  59,  60 
Phlebitis,  bandage  in,  227 
chronic,  treatment  of,  228 
indications  for  treatment,  227 
Polarity  with  the  wave  current,  9 
Potential  of  currents  depends  upon,  4 
of  delivery,  regulation  of,  35 
of  delivery,  of  resonator  spark,  39 
Prostatitis,  cause  of  neurasthenia,  198 
causes  of,  217 
electrodes    employed    in    treatment 

of,   218 
illustrated  case  report,  221 
length    of    spark-gap    in   treatment 

of,  218 
malignant,  218 
malignant  diseases  to  be  considered 

in  treatment  of,  224 
prognosis  in,  218 

rate   of   spark    discharge   in   treat- 
ment of,  220 
regulation    of    terminal     balls     in 

treatment  of,  219 
technique  of  treatment,  218 
treatment    discovered    by    author, 

220 
treatment  of   by   author's   method, 

217 
tubercular,  treatment  of,  218 
tuberculosis    to    be    considered     in 
treatment  of,  224 
Protoplasmic  contractions  induced  hj 
static  currents,  65 


272 


INDEX 


Psoriasis,    convective     discharges     in 

treatment  of,  51 
Pterygium,    treatment    of    by    direct 

vacuum  tube  current,  229 
Pulmonary    tuberculosis,    indications 

for  treatment,  243 
Fyosalpinx,  treatment  of,  247 

Radiant  energy  induced  by  electrical 
discharges,   158 
penetration  of  compared  with  high 
frequency  currents,  241 

Radiant    light   and    heat,    effects    of, 
173 
effects   upon   deep   reflexes,   173 
in  atonic  conditions,  226 
in  constipation,  226 
in  herpes  zoster,  197 
in  the  treatment  of  infection,   157 

Rays,  beta  of  radium,  57 

Rectifier,  Cooper-Hewitt,   103,  104 
electrolytic,  104 
high  potential  rotary,  93 

Rectum,  ulcers  of,  232 

Reflex  neuroses,  derangements  of  the 
stomach  and  intestinal  canal  in, 
200 

Resistance  when  lowered,  favors  in- 
fection, 237 

Resonator,    detonating    chamber    im- 
portant feature  of,   108 
essential  parts  of,  106,  108 
features  of,  108 
high  frequency,  105 
types  of,  36,  37 

Resonator     sparks,     applied     to     ab- 
scesses, 69 
effects  of,  39 

in  treatment  of  angiomata,  70 
In  treatment  of  eczema,  69 
in  treatment  of  felons,  69 
in  treatment  of  lupus,  69 
in  treatment  of  small  joints,  69 
in  treatment  of  tonsilitis,  69 
in  treatment  of  ulcers,  69 
method  of  administering,  40,  69 
with  vacuum  tubes,  66 

Rheostat,  illustration  of,  101 

Rheumatism,  infectious  arthritis,  211 

Rheumatoid    arthritis,    static    sparks 
in  treatment  of,  37 
treatment  of,  211 

Riggs'  disease,  method  of  treatment 
with  vacuum  tubes,  71 

Riviere,  Dr.  J.  A.,  effluvation  of,  249 


Roentgen   ray   in   acute   and    chronic 
appendicitis,  247 

in  infectious  arthritis,  244 

in  infectious  conditions,   156,   244 

in  pelvic  infection,  244 

in  the  treatment  of  infection,  156 

In  treatment  of  infectious    arthri- 
tis, 244 

in  treatment   of   infectious   inflam- 
mation, 238 

in  treatment  of  tubercular   arthri- 
tis, 244 

in  tubercular  arthritis,  244 
Rubefacience     from     convective     dis- 
charges, 47 

therapeutic  indications  for,  48 
Rhumkorff    coil,    insulation    between 
primary  and  secondary,  86 

methods  of  winding,  85,  86 

secondary  of,  85 

variations  in,  85 

Salpyngitis,    treated     by     high    fre- 
quency currents,  242 
treatment  of,  247 
Sclerosis,   lateral,   treatment   of,    191 
Secretions,    effects    of     vacuum     dis- 
charges on,  70 
effects  of  wave  current  upon,  15 
excessive,    effect    of    vacuum    dis- 
charges on,  69,  70 
Sheldon,  Dr.  Samuel,  73 
Sigmoid,  treatment  of,  38 
Small    joints    treated    by    resonator 

sparks,  69 
Snow,  Dr.  Arnold,  233 

electrodes   of    for   treating    uterine 

congestion,  215 
rectal  electrode,  hemorrhoidal,  232 
Solenoids,    variations    in    for    static 

machines  and  coils,  106 
Spark  director,  author's,  35 

method  of  using,  35,  36 
Spark   discharge  not  positive   within 
the  tissues,  158 
rate  of  in  treatment  of  prostatitis, 
218 
Spark-gap  in   static  induced  current, 
27 
length   of   in   treatment  of  prosta- 
titis, 218 
with  the  wave  current,  7,  20 
Sparks,  indirect,  33 

indirect,  arrangement  for,  33,  34 
in  inflammatory  exudates,  21 
potential  of  delivery  defined,  39 


INDEX 


273 


Sparks,  resonator,  33 

resonator,  apparatus  for,  38,  39 
resonator,     disruptive,     discharges 

with,   39 
sources  of,  36 

static,  exphination  of  action,  21 
Spastic  paraplo^'iu,  treatment  of,  191 
Specific   condition,   effects  of  vacuum 

tube  discluirges  on,  70,  71 
Speed  controller,   mechanical,    101 
Splivjjmomunometer,     aneroid      type, 
'l62 
Rivi   Kocca,  162 
types  of,  162 
Spinal  cord,  diseases  of,  183 

railroad    injury,    report    of    cases, 

183,   184 
treatment  of  injuries  of,  184 
Spleen,  enlargement  of,  treatment  of, 

225 
Sprained     ankle,     static     sparks     in 

treatment  of,   38 
Sprains,  treatment  of,  210 
Spray,  static,  41,  42 

compared  to  the  brush  discharge,  42 
electrodes  for,  42 
Stasis,  dissolution   of   by   static   cur- 
rent,  207 
not  relieved  by  hyperemia,  240 
Static  brush  discharge  administration 
of  in  the  cavities  of  the  body, 
brush  discharge  in  chilblains,  232 
brush  discharge  in  echymnsis,  234 
brush  discharge  in  phlebitis,  228 
brush  discharge  in  psoriasis,  51 
brush  discharge  in  ulcers,  228 
currents,     effects     of     in     anterior 

poliomyelitis,  186 
currents  in  diseases  of  the  cord,  183 
currents   in    treatment   of    hemorr- 
hoids, 233 
currents  in  treatment  of  inflamma- 
tions, principles  of,  207 
currents  in  treatment  of  stasis,  206 
currents    in    various    types    of    in- 
flammation, 206 
currents  produce  contraction  of  cell 

protoplasm, 
induced    and    wave    currents    com- 
pared, 32 
induced   current,   79 
induced  current   advantages  of,  30 
induced     current    arrangement    of 

Leyden  jars  with,  31 
induced     current     compared     with 
other  currents,  30 


Static,  induced  current  discovery  of, 
25 

induced    current    name    technically 

accurate,  29 
induced    current    physiological    ac- 
tions, 29,  30 
iiuhiced  current,  vacuum  electrodes 

with.  31 
iiidiKi'd    current,    with    the    metal 

clctrodes,   :i\ 
induced  current  with  vacuum  elec- 
trodes, 07,  68 
machine  choice  of  for  vacuum  tube 

discharges,    65 
machine    device    of    for    wave   cur- 
rent, 8 
machine  method  of  auto-conduction 

with,  179,  180 
methods  for  auto-conduction,  120 
methods  revolutionary,  200 
resonator,  deKraft  type,  122 
sparks,   ball    for   administering,   39 
sparks  in  brachial  neuritis,  37 
sparks  in  chronic  inflammation,  39 
sparks    in    deep    seated    inflamma- 
tions, 37 
sparks  in  muscular  spasm,  38 
sparks  in  neuritis,  39,  19G 
sparks  in  rheumatoid  arthritis,  37 
sparks  in  sprained  ankle,  38 
sparks  in  treatment  of  joints,  38 
sparks    length    regulated   to   condi- 
tion, 39 
sparks    long,    in    locomotor    ataxia, 

188 
sparks  method  of  applying,  38 
sparks  pain  objectionable,  37 
sparks  relieve  muscular  spasms,  37 
sparks   remove    infiltration,   37 
sparks  technique  of  importance,  37 
sparks   therapeutic  indications   for 

36 
spray,  41,  42 
wave  current,  77 

wave  current   and   d'Arsonval   cur- 
rent compared,   130 
wave    current    care    in    administer- 
ing. 148 
wavo  current   illustrationg  current 

direction,    131 
wave  current  in  constipation.  226 
wave  current  in  dysmenorrhea,  212 
wave  current   in  gonorrheal  arthri- 
tis, 245 
wave  current  in  interstitial  nephri- 
tis, 226 


274 


INDEX 


static    wave    current    in    locomotor 
ataxia,   188 
wave  current  in  nephritis,  169 
wave  current,  in  neuritis,  195 
wave    current    in    parenchymatous 

nephritis,  225 
wave  current  in  subinvolution,  212;. 

213 
wave  current  in  treatment  of  cir- 
rhosis, 225 
wave  current  in  treatment  of  cir- 
rhotic liver,  172 
wave  current  in  treatment  of  neph- 
ritis,  169 
wave  current  in  urethral  caruncles, 

216 
wave  current  mechanical  effects  of, 
132 
Step  up  solenoids  illustrated,  110 
Still's  disease,  treatment  of,  211 
Stimulating   effects   of    vacuum    tube 

discharges,  62 
Subinvolution,    treatment    of    by    au- 
thor's method,  214 
Suggestion,   auto,   in    neuroses,   func- 
tional, 200 
Suppurative    process    in    the    frontal 

sinuses,  treatment  of,  241 
Surgery   in   gynecology,   disturbances 

from,  199 
Syphilitic  processes,  wave  current  not 

adapted  to,  22 
Syringo  myelia,  treatment  of,  191 

Tabes    dorsalis,    anesthetic    areas    in, 
187 
see  locomotor  ataxia,  187 
Tear    duct   congestion,   treatment   of, 

230 
Terminal    balls,    regulation    of    sizes 

for  treatment,  219 
Tesla  apparatus,  96 
coils,  so  called,  97,  98 
current   described    and    illustrated, 

80,   121 
current  for  effluvation,  124 
current  so  styled,   121 
Oudin     and     d'Arsonval     currents 

compared,  79 
particular  advantages   of,   100 
rectifier,  94 
Therapeutic   indications   for    employ- 
ment of  vacuum  electrodes,  67 
Tliermic   effects    of  the   direct   d'Ar- 
sonval method,  241 


Thermic    effects    of    high    frequency 
currents,   148 
toleration,   usual    rule    for   dosage, 
242 
Thompson,  Prof.  Elihu,  73 
Tic  douloureux,  treatment  of,  197 
Tiee,   Dr.  F.   C,  method   of   treating 

hay  fever,  232 
Tonic  effects  of  currents  of  high  peri- 
odicity, 83 
Tonsilitis       treated      by       resonator 
sparks,  69 
suppurative,  treatment  of,  239 
Toxemia,  causes  of  arthritis,  211 
Transformer,  closed  magnetic  circuit, 
92 
interrupterless,  92 
new  types  of,  99 
Ti-eatment  of  local  infection,  237,  238 
Tubercular  adenitis,  combined  method 
of  treatment,  242,  244 
adenitis,  direct  d'Arsonval  current 

in,  244 
adenitis,  Roentgen  ray  in,  244 
affections,     general     principles     of 

treatment,  245 
affections,  local  treatment  of,  245 
arthritis,  diagnosis  of,  22 
arthritis.    Roentgen    ray   in    treat- 
ment of,  244 
arthritis,  treatment  of,  244 
Tuberculosis,  pulmonary,  direct  d'Ar- 
sonval currents  in,  243 
pulmonaiy,  hyperemia  in,  243 
pulmonary,    indications    for    treat- 
ment, 243 
pulmonary,  Roentgen  ray  in,  243 
pulmonary,  treatment  of,  243 
to  be   considered    in    treatment   of 
prostatitis,  224 

Ulcerated    surfaces,    convective    dis- 
charges in,  51 

treated  by  deKraft  method,  124 
Ulcers   of  the  cornea,   treatment  of, 
229 

of  the  eye  ball,  treatment  of,  229 

of  the  rectum,  232 

post-nasal,  treatment  of,  231 

treated  by  resonator  sparks,  69 

varicose,  treatment  of,  228 
Urethral  caruncle,  treatment  of,  216 
Uterine  congestion,  prognosis  in,  213 

subinvolution,  treatment  of,  214 


INDEX 


275 


Vacuum    current    direct    from    static 
effective,  66,  67 
current   direct   induce   local  vibra- 
tion, 65 
current  direct  in  treatment  of  fel- 
ons, 239 
current  direct  in  treatment  of  fur- 
uncles. 239 
current  direct  in  treatment  of  sup- 
purative tonsilitis,  239 
current  direct  in  urethral  caruncle, 

216 
current  direct  physiological  effects 

of,  61 
currents,  cataphoric  action  of,  71 
currents,  effects  of  on  metabolism,  71 
discharges,  distinction  of.  .54,  .').5 
discharges   for   induction  of   hyper- 
emia, 239 
discharges  for  the  relief  of  pain,  72 
discharges  in  Riggs'  disease,  71 
discharges  in   the  treatment  of  in- 
fection, 239 
discharges    local     heat    production 

with,  67 
discharges  phenomenon  of  the  high 

potential  discharges.  55 
discharges  rubefacient  effects  of.  62 
discharges  stimulating  effects  of,  62 
discharges,   therapeutic   indications 

for  employment  of.  67 
electrodes    chemical   effects   of  dis- 
charges, 60,  61 
electrodes,   color    effects   in.    59 
electrodes,    with    coil    of    resonator 

current,  69 
electrodes  with  d'Arsonval  current, 

239 
electrodes  with  high  potential  cur- 
rents, 54 
electrodes  with  resonator  sparks.  66 
electrodes  with   static  induced  cur- 
rent, 31,  68 
Vaginismus,  treatment  of,  217 
Varicocele,    treatment    of,    223 
Vesiculitis,  treatment  of,  223 
Vibration,   local,   induced   by  vacuum 
tube  discharges,  65 
merhanioal,  in  constipation.  226 

\\'ave  current  and  static  induced  c\ir- 
rent  compared,  32 
arrangement  of,  6.  7 
athetosis,   inrtirablo.   23 
connecting  oords.  H 
constitutional  effecta  of,  13 


Wave    current,     contraction     of    cell 
protoplasm   by,   12 
contraindicated    in    malignant    dis- 
eases, 224 
contraindicated  in  tnl)erculosis,  224 
distinctive   characteristics  of,  9 
effects  of  vibration,  11 
effects  in  heat  production,  14.  15 
effects  on  arterial  tension,  14 
effects  on  <ligestion,    16 
effects  on  metabolism,  10,  13 
effects  on  muscular  contraction,  11 
effects  upon  blood  pressure,   132 
effects  upon  metabolism  in  nephri- 
tis, 172 
effects  upon  the  secretions,  15 
elimination  by,    13,  14 
fatigue  from  administration,   16 
general  diffusion,  9 
grounding  chain  in,  8 
in  acute  congestion,  19,  20 
in  conditions  of  inertia,  24.  25 
in  deep  seated  conditions,  20 
indications  for  use  of,  17 
in  errors  of  metabolism,  23,  24 
in  hypertension,  174 
in   inflammatory   exudates,  21,   22 
in  nervous  irriiability,  23 
intensity  of  discharges,  9 
in  the  diagnosis  of  tubercular  arth- 
ritis, 22 
metallic  electrodes  in,  8 
muffler  with,  20,  21 
muscular  spasm,  23 
not  adapted  to  gonorrheal  rheuma- 
tism, 22 
not  adapted  to  syphilitic  processes, 

22 
of   one    polarity,   9 
on  special    functions,  effects.  24 
physiological   effects  of,  9,   10 
principles  of  action  and   therapeu- 
tics, 6 
relief  of  pain  by,  22,  23 
size  of  electrodes  with,   20 
spark-gap  in.  8 
spark-gap  with,  20 
st-atic.    principles    of    indication    in 
nephritis,    173 
Wehnelt   interrupter,  87 
Wright,  Dr..   155,  237 
opinions.  237 

ZoBter,   herpes,    196 


THIS  BOOK  IS  DUE  O'N  THE  LAST  DATE 
STAMPED  BELOW 


'^'i^ 

OCT  6  11920 

'JUL  30  1921 

H9V  S7  itit 

MAk  jJ6  1941 

1 

30»i-6,'14 

.y 


YD055036 


A 


at 


oHJW 


22/931 

4^ 


